Doc Eye LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

DOC EYE LLC

Practice address

155 Waterford Pkwy N
Waterford, CT 06385-1208

Phone

(860) 215-4009

Fax

(518) 217-6004

NPI assigned

Oct 7, 2022

Last updated

Feb 26, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Keith Edward Watson, ODNPI 1194795948

Title

Owner / Manager

Phone

(860) 215-4009

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Practitioners 1

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.

• Keith Watson

  • Optometrist
  • Albany, NY
  • NPI 1194795948

  CT

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1665100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677369600000",
    "number": "1811612252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 AVALON PINES DR",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117275151",
            "telephone_number": "202-909-6805",
            "fax_number": "518-217-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 WATERFORD PKWY N",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063851208",
            "telephone_number": "860-215-4009",
            "fax_number": "518-217-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOC EYE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-07",
        "last_updated": "2023-02-26",
        "certification_date": "2023-02-26",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER / MANAGER",
        "authorized_official_telephone_number": "860-215-4009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008114807",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mallory Rose Devona, MS, NCC, LPC
• Aurora Clark Dibner, D.M.D
• Clarisse G Dicandia, PSYD
• Katelyn Dillon, M.S., CCC-SLP
• Linda Dipesa, LCSW
• Sarah Dolan
• Cristina Dominijanni, PH.D.
• David A Doyle, PT
• John E Dreslin, DMD
• John R Drew, D.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 Feb 26, 2023; 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.