Kevin So, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2754 Issued in CT

Practice address

604 Lakewood Rd
Waterbury, CT 06704-2419

Phone

(203) 575-0900

NPI assigned

Aug 28, 2009

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

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, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Connecticut LLCGroup PAC ID 1557666237, 70 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Myeyedr Optometry of Connecticut, LLC

  • Optometrist
  • Ansonia, CT
  • NPI 1396119194
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Connecticut, LLC

  • Optometrist
  • Torrington, CT
  • NPI 1184098808
  NPD
• Myeyedr Optometry of Connecticut, LLC

  • Optometrist
  • Vernon, CT
  • NPI 1992207468
  NPD
• Myeyedr Optometry of Connecticut, LLC

  • Optometrist
  • Greenwich, CT
  • NPI 1639902711
  NPD (past)
• Richard a Fichman MD PC

  • Optician
  • Manchester, CT
  • NPI 1053591214
  NPD (past)
• Wallingford Eye Care Center P.C.

  • Optometrist
  • Wallingford, CT
  • NPI 1053521419
  NPD (past)

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

{
    "created_epoch": "1251417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1710110390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 LAKEWOOD RD",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067042419",
            "telephone_number": "203-575-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SO",
        "first_name": "KEVIN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-28",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "2754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• SMS Home Care Agency LLC
• SMS Home Care Agency LLC
• SNF Physiatry Services CT PLLC
• Matthew Gordon Snow, PSYCHOLOGIST
• Jackie Snyder, COUNSELOR
• Lori Sobel, M.D.
• Cheryl Sobieraj Wadhwa, DDS
• Andre N Sofair, MD
• Kaitlin Sohn, MFT,BA
• Joseph L Sokol, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; 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.