NPIMap

Organization Active NPI

The Eye Care Group

  • Eyewear Supplier
  • Orange, CT
National Provider Identifier
1790114866
Registry record updated May 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
001610 Issued in CT
Legal business name
THE EYE CARE GROUP
Practice address
250 Indian River Road
Orange, CT 06477
Phone
(203) 597-9100
Fax
(203) 573-4805
NPI assigned
Nov 8, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2017

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

Authorized official

Name
Cheryl Dulina
Title
Credentialing Coordinator
Phone
(203) 573-4803

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 001610 CT Primary

Addresses

Primary practice location

250 Indian River Road
Orange, CT 06477

Mailing address

1201 West Main Street
Suite 100
Waterbury, CT 06708
Phone (203) 573-4803

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140204001388 CT DME Supplier - Physician - OphthalmologyDME Supplier - Optician 6103876628 Practice locations: Orange, CT

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
07D1060352Eye Care Group,the250 Indian River Rd, Orange, CT 06477Certificate of waiverOct 19, 2026

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
The Eye Care Group250 Indian River Rd, Orange, CT 06477-3695(203) 597-9100 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 1994

National Provider Directory

National Provider Directory
Tax ID family
The Eye Care Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6 Business Park Dr
#102
Branford, CT 06405
Phone (203) 488-5411

1201 W Main St
#200
Waterbury, CT 06708

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495584000000",
    "number": "1790114866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 WEST MAIN STREET",
            "address_2": "SUITE 100",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06708",
            "telephone_number": "203-573-4803",
            "fax_number": "203-573-4805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 INDIAN RIVER ROAD",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "06477",
            "telephone_number": "203-597-9100",
            "fax_number": "203-573-4805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE EYE CARE GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-08",
        "last_updated": "2017-05-24",
        "status": "A",
        "authorized_official_last_name": "DULINA",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "203-573-4803"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "CT",
            "license": "001610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.