Individual provider Active NPI

Pamela M Matuszewski, OD

  • Optometrist
  • Farmington, CT
National Provider Identifier
1689750002
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
002013CT Issued in CT
Practice address
300 Westfarms Mall
Farmington, CT 06032-2633
Phone
(860) 561-4189
Fax
(860) 521-5768
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 002013CT CT Primary

Addresses

Primary practice location

300 Westfarms Mall
Farmington, CT 06032-2633

Mailing address

300 Westfarms Mall
Farmington, CT 06032-2633
Phone (860) 561-4189

Other practice location 1

475 Hartford Rd
New Britain, CT 06053-1524
Phone (860) 826-1052

Other identifiers 3

IdentifierTypeStateIssuer
1689750002Other1689750002
609404OtherCTCONNECTICORE
090002013CT04OtherCTBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20111228000574 CT Practitioner - Optometry 4486820271 Practice locations: Farmington, CT

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1984
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

300 W Farms Mall
Farmington, CT 06032-2633

300 Westfarms Mall
Farmington, CT 06032-2633
Phone (860) 561-4189

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002013CTCTMDOptometrist
2013CTMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1689750002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 WESTFARMS MALL",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060322633",
            "telephone_number": "860-561-4189",
            "fax_number": "860-521-5768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 WESTFARMS MALL",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060322633",
            "telephone_number": "860-561-4189",
            "fax_number": "860-521-5768"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "475 Hartford Rd",
            "address_purpose": "LOCATION",
            "city": "New Britain",
            "state": "CT",
            "postal_code": "060531524",
            "country_code": "US",
            "telephone_number": "860-826-1052",
            "fax_number": "860-826-7047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATUSZEWSKI",
        "first_name": "PAMELA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "002013CT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1689750002",
            "identifier": "1689750002",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICORE",
            "identifier": "609404",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "090002013CT04",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.