NPIMap

Organization Active NPI

Jeffrey L. Morer, OD, PC

  • Optometrist
  • Middletown, CT
National Provider Identifier
1679504161
Registry record updated Dec 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
JEFFREY L. MORER, OD, PC
Practice address
101 Centerpoint Dr Ste 215
Middletown, CT 06457-7568
Phone
(888) 964-6681
Fax
(888) 662-0859
NPI assigned
Jul 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jeffrey L. Morer, ODNPI 1972536175
Title
Owner/President
Phone
(617) 964-6681

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

101 Centerpoint Dr Ste 215
Middletown, CT 06457-7568

Mailing address

100 Crossing Blvd
Suite 300
Framingham, MA 01702-5555
Phone (617) 964-6681

Other identifiers 3

IdentifierTypeStateIssuer
004124658MedicaidCT
CA5924OtherCTMEDICARE RAILROAD
50HEALTHDCT01OtherCTBLUE CROSS BLUE SHIELD

Other names 1

  • HealthDrive Eye Care Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040203000875 CT Part B Supplier - Clinic/Group Practice 7719870807 Receives reassigned benefits from 6 practitioners
Practice locations: Middletown, CT

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Healthdrive Eye Care11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

888 Worcester St
Ste 130
Wellesley, MA 02482
Phone (857) 255-0293

Ownership & related parties

All facility ownership & control disclosures 18

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Carmel Health & Living CommunityCarmel, IN, CCN 155181 Skilled nursing facility Adp of the SNF Mar 7, 2019
Countryside Manor Health & Living CommunityAnderson, IN, CCN 155258 Skilled nursing facility Adp of the SNF Mar 7, 2019
Rawlins House Health & Living CommunityPendleton, IN, CCN 155357 Skilled nursing facility Adp of the SNF Mar 7, 2019
Harbour Manor Health & Living CommunityNoblesville, IN, CCN 155381 Skilled nursing facility Adp of the SNF Mar 7, 2019
Brown County Health & Living CommunityNashville, IN, CCN 155487 Skilled nursing facility Adp of the SNF Mar 7, 2019
Paoli Health & Living CommunityPaoli, IN, CCN 155333 Skilled nursing facility Adp of the SNF Mar 7, 2019
Arbor Trace Health & Living CommunityRichmond, IN, CCN 155481 Skilled nursing facility Adp of the SNF Mar 7, 2019
Altenheim Health & Living CommunityIndianapolis, IN, CCN 155196 Skilled nursing facility Adp of the SNF Mar 7, 2019
Morristown ManorMorristown, IN, CCN 155691 Skilled nursing facility Adp of the SNF Mar 7, 2019
Brookside Village, IncJasper, IN, CCN 155703 Skilled nursing facility Adp of the SNF Mar 7, 2019
Hamilton Trace of FishersFishers, IN, CCN 155793 Skilled nursing facility Adp of the SNF Mar 7, 2019
Aspen Trace Health & Living CommunityGreenwood, IN, CCN 155821 Skilled nursing facility Adp of the SNF Mar 7, 2019
Cumberland Trace Health & Living CommunityPlainfield, IN, CCN 155836 Skilled nursing facility Adp of the SNF Mar 7, 2019
University Heights Health and Living CommunityIndianapolis, IN, CCN 155327 Skilled nursing facility Adp of the SNF Mar 7, 2019
Copper Trace Health & Living CommunityWestfield, IN, CCN 155841 Skilled nursing facility Adp of the SNF Mar 7, 2019
Greenwood Health and Living CommunityGreenwood, IN, CCN 155412 Skilled nursing facility Adp of the SNF Mar 7, 2019
Bell Trace Health and Living CenterBloomington, IN, CCN 155677 Skilled nursing facility Adp of the SNF Mar 7, 2019
Lincoln Hills of New AlbanyNew Albany, IN, CCN 155614 Skilled nursing facility Adp of the SNF Mar 7, 2019

Owned or controlled facilities with NPI records 19

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 19

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577750400000",
    "number": "1679504161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CROSSING BLVD",
            "address_2": "SUITE 300",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017025555",
            "telephone_number": "617-964-6681",
            "fax_number": "339-686-2561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CENTERPOINT DR STE 215",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064577568",
            "telephone_number": "888-964-6681",
            "fax_number": "888-662-0859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY L. MORER, OD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A",
        "authorized_official_last_name": "MORER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "617-964-6681",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004124658",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CA5924",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "50HEALTHDCT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthDrive Eye Care Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HealthDrive Eye Care Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.