Individual provider Active NPI

Michelle Reichle

  • Optometrist
  • East Hartford, CT
National Provider Identifier
1710026133
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
002634 Issued in CT
Practice address
893 Main St Ste 201
East Hartford, CT 06108-2293
Phone
(860) 528-5816
Fax
(860) 290-5356
NPI assigned
Feb 5, 2007
Last updated
Mar 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 002634 CT Primary

Addresses

Primary practice location

893 Main St Ste 201
East Hartford, CT 06108-2293

Mailing address

893 Main St Ste 201
East Hartford, CT 06108-2293
Phone (860) 528-5816

Other practice location 1

282 Washington St
Hartford, CT 06106-3322
Phone (860) 837-9600

Other identifiers 1

IdentifierTypeStateIssuer
004260460MedicaidCT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MichelleReichlePrignano_CT_356@PracticeDirector.direct-ci.com

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
I20050603000210 CT Practitioner - Optometry 6305889072 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002634CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Children's Specialty Group, Inc. Optometrist CurrentSince Nov 28, 2022 Accepting new patients
Connecticut Children's Specialty Group, Inc. CurrentSince Nov 28, 2022 Accepting new patients

Locations

10 Columbus Blvd
Hartford, CT 06106
Phone (860) 837-5619

282 Washington St
Hartford, CT 06106
Phone (860) 545-8950

Interoperability endpoints

  • Direct secure messaging: michellereichleprignano_ct_356@practicedirector.direct-ci.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1710026133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "893 MAIN ST STE 201",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061082293",
            "telephone_number": "860-528-5816",
            "fax_number": "860-290-5356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "893 MAIN ST STE 201",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061082293",
            "telephone_number": "860-528-5816",
            "fax_number": "860-290-5356"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "282 Washington St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061063322",
            "country_code": "US",
            "telephone_number": "860-837-9600",
            "fax_number": "860-837-9601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REICHLE",
        "first_name": "MICHELLE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "002634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004260460",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MichelleReichlePrignano_CT_356@PracticeDirector.direct-ci.com",
            "affiliation": "N",
            "address_1": "282 Washington St",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061063322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in East Hartford, CT

Sources for this page

Verify at the official NPI Registry.