Organization Active NPI

Family Optometric Care PC

  • Optometrist
  • Bloomfield, CT
National Provider Identifier
1780656579
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
FAMILY OPTOMETRIC CARE PC
Practice address
38 Tunxis Ave
Suite 1
Bloomfield, CT 06002-2034
Phone
(860) 243-2508
NPI assigned
Feb 6, 2006
Organization subpart
Yes
Parent organization
FAMILY OPTOMETRIC CARE PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Authorized official

Name
Bradford Alan Newman, O.D.
Title
President
Phone
(860) 243-2508

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X CT Primary

Addresses

Primary practice location

38 Tunxis Ave
Suite 1
Bloomfield, CT 06002-2034

Mailing address

38 Tunxis Ave
Suite 1
Bloomfield, CT 06002-2034
Phone (860) 243-2508

Other identifiers 1

IdentifierTypeStateIssuer
004163036MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050517000434 CT Part B Supplier - Clinic/Group Practice 6800837162 Receives reassigned benefits from 2 practitioners
Practice locations: Bloomfield, CT

National Provider Directory

National Provider Directory
Part of
Family Optometric Care

Locations

41 Wintonbury Mall
Bloomfield, CT 06002
Phone (860) 243-2508

38 Tunxis Ave
Ste 1
Bloomfield, CT 06002
Phone (860) 243-2508

1061 Silas Deane Hwy
#I
Wethersfield, CT 06109
Phone (860) 563-8207

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666656000000",
    "number": "1780656579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 TUNXIS AVE",
            "address_2": "SUITE 1",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060022034",
            "telephone_number": "860-243-2508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 TUNXIS AVE",
            "address_2": "SUITE 1",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060022034",
            "telephone_number": "860-243-2508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY OPTOMETRIC CARE PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILY OPTOMETRIC CARE PC",
        "enumeration_date": "2006-02-06",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A",
        "authorized_official_last_name": "NEWMAN",
        "authorized_official_first_name": "BRADFORD",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-243-2508",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004163036",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.

Verify at the official NPI Registry.