Individual provider Active NPI

Gemma Soliman Stirba, OD

  • Optometrist
  • Danielson, CT
National Provider Identifier
1790701878
Registry record updated May 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
002686 Issued in CT
Practice address
25 Green Hollow Rd
Danielson, CT 06239-3509
Phone
(860) 779-1588
Fax
(860) 779-1754
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 002686 CT Primary

Addresses

Primary practice location

25 Green Hollow Rd
Danielson, CT 06239-3509

Mailing address

25 Green Hollow Rd
Danielson, CT 06239-3509
Phone (860) 779-1588

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20060922000366 CT Practitioner - Optometry 4082619143 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Killingly Eye Care P.C. 3 clinicians

Practice addresses (Care Compare)

25 Green Hollow Rd
Danielson, CT 06239-3509
Phone (860) 779-1588

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2686CTMDRegistered Dietitian
002686CTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Killingly Eye Care P.C. Optometrist CurrentSince Jun 6, 2011 Accepting new patients

Locations

25 Green Hollow Rd
Danielson, CT 06239
Phone (860) 373-4148

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432166400000",
    "number": "1790701878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 GREEN HOLLOW RD",
            "city": "DANIELSON",
            "state": "CT",
            "postal_code": "062393509",
            "telephone_number": "860-779-1588",
            "fax_number": "860-779-1754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 GREEN HOLLOW RD",
            "city": "DANIELSON",
            "state": "CT",
            "postal_code": "062393509",
            "telephone_number": "860-779-1588",
            "fax_number": "860-779-1754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIRBA",
        "first_name": "GEMMA",
        "middle_name": "SOLIMAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2015-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "002686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danielson, CT

Sources for this page

Verify at the official NPI Registry.