Ronald L Medwick, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

CT753 Issued in CT

Practice address

567 Vauxhall Street
Waterford, CT 06385

Phone

(860) 442-1466

Fax

(860) 442-3191

NPI assigned

Sep 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Pennsylvania College of Optometry, 1972

Medicare assignment

May accept Medicare assignment

Group practices

Waterford Optometric PCGroup PAC ID 4789024985, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Waterford Optometric PC

  • Optometrist
  • Waterford, CT
  • NPI 1154174589
  Medicare reassignment Care Compare group NPD (past)
• Optometric Associates,P.C

  • Optometrist
  • Waterford, CT
  • NPI 1316107543
  NPD Authorized official

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232496000000",
    "number": "1790881696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "567 VAUXHALL STREET",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "06385",
            "telephone_number": "860-442-1466",
            "fax_number": "860-442-3191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "567 VAUXHALL STREET",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "06385",
            "telephone_number": "860-442-1466",
            "fax_number": "860-442-3191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDWICK",
        "first_name": "RONALD",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2009-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "CT753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004080941",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lloyd P McDonald, D.D.S.
• Hayley McGill, OTR/L
• Courtney McLeod
• Edda H McManus, LCSW
• Medstar Surgical & Breathing Equipment, Inc.
• Louise Mega, PT
• Kalie Menders
• Mark Mikkelson, R.PH.
• Peter Milstein, M.D.
• Francis Gervan Mlynarski, M.D.

• Optometrist in Waterford, CT
• Providers in Waterford, CT by specialty
• Optometrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.