Individual provider Active NPI

Kevin Burke Cranmer, M.D.

  • Ophthalmology Physician
  • Norwich, CT
National Provider Identifier
1790740934
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
044355 Issued in CT
Practice address
12 Case St Ste 215
Norwich, CT 06360-2222
Phone
(860) 373-4148
Fax
(860) 908-2353
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 044355 CT Primary

Addresses

Primary practice location

12 Case St Ste 215
Norwich, CT 06360-2222

Mailing address

12 Case St Ste 215
Norwich, CT 06360-2222
Phone (860) 373-4148

Other identifiers 5

IdentifierTypeStateIssuer
001443556MedicaidCT
P00734658OtherCTMEDICARE RAILROAD
044355OtherCTCONNECTICARE
2679264OtherCTUNITED HEALTHCARE
3V1443OtherCTHEALTHNET

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060718000097 CT Practitioner - Ophthalmology 4880607746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Harvard Medical School, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Connecticut Eye Care LLCGroup PAC ID 2769755255, 3 clinicians

Practice addresses (Care Compare)

1041 Poquonnock Rd
Groton, CT 06340-4211
Phone (860) 373-4148

Hospital & facility affiliations

  • Hartford Hospital Hospital, Hartford, CT, CCN 070025
  • Lawrence & Memorial Hospital Hospital, New London, CT, CCN 070007
  • William W Backus Hospital Hospital, Norwich, CT, CCN 070024

Merit-based Incentive Payment System (MIPS)

Final score
54.62 of 100Reported as individual
Quality
0
Improvement activities
40
Cost
79.15

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery334
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
044355CTMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Connecticut Eye Care, LLC Ophthalmology CurrentSince Jul 1, 2017 Accepting new patients

Locations

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

1041 Poquonnock Rd
Groton, CT 06340
Phone (860) 373-4148

12 Case St
Ste 215
Norwich, CT 06360
Phone (860) 373-4148

16 Walnut St
Willimantic, CT 06226
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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1790740934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 CASE ST STE 215",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602222",
            "telephone_number": "860-373-4148",
            "fax_number": "860-908-2353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 CASE ST STE 215",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602222",
            "telephone_number": "860-373-4148",
            "fax_number": "860-908-2353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANMER",
        "first_name": "KEVIN",
        "middle_name": "BURKE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CT",
            "license": "044355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001443556",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00734658",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "044355",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2679264",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "3V1443",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

Verify at the official NPI Registry.