Active NPI
Myeyedr Optometry of Connecticut, LLC
- Optometrist
- Watertown, CT
National Provider Identifier
1780058404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- MYEYEDR OPTOMETRY OF CONNECTICUT, LLC
- Doing business as
- MyEyeDr.
- Practice address
- 997 Main St
Watertown, CT 06795-2914 - Phone
- (860) 274-7576
- NPI assigned
- Nov 18, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sue Downes
- Title
- Secretary
- Phone
- (703) 847-8899
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary |
Addresses
Primary practice location
997 Main St
Watertown, CT 06795-2914
Mailing address
8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899
Other names 1
- MyEyeDr.
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160217001075 | CT | Part B Supplier - Clinic/Group Practice | 1557666237 |
Receives reassigned benefits from 126 practitioners 33 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Norwalk, CT; Orange, CT; Ridgefield, CT; Rocky Hill, CT; Shelton, CT; South Windsor, CT; Southbury, CT; Suffield, CT… |
Other NPIs on the same Medicare enrollment 33
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryLocations
997 Main St
Watertown, CT 06795
Phone (860) 274-7576
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- New Haven, CT
- NPI 1306983648
-
- Optometrist
- Watertown, CT
- NPI 1528574415
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447804800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1653264000000",
"number": "1780058404",
"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",
"fax_number": "571-223-6780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "997 MAIN ST",
"city": "WATERTOWN",
"state": "CT",
"postal_code": "067952914",
"telephone_number": "860-274-7576"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MYEYEDR OPTOMETRY OF CONNECTICUT, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-11-18",
"last_updated": "2022-05-23",
"certification_date": "2022-05-23",
"status": "A",
"authorized_official_last_name": "DOWNES",
"authorized_official_first_name": "SUE",
"authorized_official_title_or_position": "SECRETARY",
"authorized_official_telephone_number": "703-847-8899"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "MyEyeDr.",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Watertown, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.