Frederick Allen Moffa, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2388 Issued in CT

Practice address

355 Salmon Brook St
Granby, CT 06035-1804

Phone

(860) 653-7440

NPI assigned

Jun 23, 2006

Last updated

Mar 17, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

New England College of Optometry, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Granby Family Eye Care

  • Optometrist
  • Granby, CT
  • NPI 1386392496
  NPD Authorized official

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1679509509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 COPPER HILL RD",
            "city": "GRANBY",
            "state": "CT",
            "postal_code": "060351524",
            "telephone_number": "860-653-7440",
            "fax_number": "860-653-7469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 SALMON BROOK ST",
            "city": "GRANBY",
            "state": "CT",
            "postal_code": "060351804",
            "telephone_number": "860-653-7440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFA",
        "first_name": "FREDERICK",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "2388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "090002388CT 04",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004172699",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary K Wimpfheimer, LLC
• Meadowbrook Center Inc (MeadowBrook of Granby)
• Lisa Meijer
• Dawn Marie Mele, MS, ATC, CSCS
• Anna Meola, DO
• Yanitza Montanez
• Jennifer Ann Morse, LMT MMT RM
• Rose-Marie Adelle Mouning
• New England Foot Care LLC
• Amy Qiu, PHARMD

• Optometrist in Granby, CT
• Providers in Granby, CT by specialty
• Optometrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.