Active NPI
Wayne Michael Levasseur, O.D.
- Optometrist
- Windsor, CT
National Provider Identifier
1669570479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 900
- Practice address
- 186 Broad St
Windsor, CT 06095-2925 - Phone
- (860) 688-1630
- Fax
- (860) 687-1324
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 900 | CT | Primary |
Addresses
Primary practice location
186 Broad St
Windsor, CT 06095-2925
Mailing address
186 Broad St
Windsor, CT 06095-2925
Phone (860) 688-1630
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 900 | CT | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669570479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "186 BROAD ST",
"city": "WINDSOR",
"state": "CT",
"postal_code": "060952925",
"telephone_number": "860-688-1630",
"fax_number": "860-687-1324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "186 BROAD ST",
"city": "WINDSOR",
"state": "CT",
"postal_code": "060952925",
"telephone_number": "860-688-1630",
"fax_number": "860-687-1324"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEVASSEUR",
"first_name": "WAYNE",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CT",
"license": "900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Windsor, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.