Richard Joseph Nowak, OD MS

Primary specialty

OptometristTaxonomy code 152W00000X

License

CT725 Issued in CT

Practice address

155 North Road
East Windsor, CT 06088

Phone

(860) 623-8217

Fax

(860) 627-7706

NPI assigned

Mar 6, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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 and National Provider Directory roles.

• Kelly Family Eyecare, LLC

  • Optometrist
  • Vernon, CT
  • NPI 1558713859
  NPD (past)

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269302400000",
    "number": "1740319441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 NORTH ROAD",
            "city": "EAST WINDSOR",
            "state": "CT",
            "postal_code": "06088",
            "telephone_number": "860-623-8217",
            "fax_number": "860-627-7706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 NORTH ROAD",
            "city": "EAST WINDSOR",
            "state": "CT",
            "postal_code": "06088",
            "telephone_number": "860-623-8217",
            "fax_number": "860-627-7706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWAK",
        "first_name": "RICHARD",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "OD MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2010-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "CT725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "398175",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONN CARE",
            "identifier": "603005",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "090000725CT01",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004023883",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Muska, DC
• My Enfield Dentist, LLC
• National Vision, Inc.
• Nccfcc
• David J Newman, RPH
• Laura Olejarz
• Mary Silva Pabilonia, PHARMD, RPH
• Partners of Connecticut LLC
• Pathways to Empowerment, LLC
• Britainy Leigh Peirce, CPHT, CSPT

• All providers in East Windsor, CT
• Optometrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.