Individual provider Active NPI

Gina M Lippi, O.D.

  • Optometrist
  • Manchester, CT
National Provider Identifier
1811913593
Registry record updated Apr 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
CT2546 Issued in CT
Practice address
194 Buckland Hills Dr Ste 1106
Manchester, CT 06042-8748
Phone
(860) 644-3364
Fax
(860) 648-0592
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X CT2546 CT Primary

Addresses

Primary practice location

194 Buckland Hills Dr Ste 1106
Manchester, CT 06042-8748

Mailing address

107 Oliver Rd
Manchester, CT 06042-2943
Phone (860) 644-3364

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
I20041025000056 CT Practitioner - Optometry 8921069816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

238 Tolland Tpke
Suite G
Manchester, CT 06042-1744
Phone (860) 646-2015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CT2546CTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Family Eyecare, LLC Optometrist CurrentSince Dec 1, 2012 Accepting new patients
Dr. Aucello & Associates, P.C. Optometrist Past Accepting new patients
Prudhomme Vision LLC Optometrist Past Accepting new patients

Locations

238 Tolland Tpke
#G
Manchester, CT 06042
Phone (860) 646-2015

238 Tolland Tpke
Manchester, CT 06042
Phone (860) 327-5990

238G Tolland Tpke
Manchester, CT 06042
Phone (860) 281-1501

Organizations & group practices 3

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": "1240444800000",
    "number": "1811913593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 OLIVER RD",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060422943",
            "telephone_number": "860-644-3364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 BUCKLAND HILLS DR STE 1106",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060428748",
            "telephone_number": "860-644-3364",
            "fax_number": "860-648-0592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPPI",
        "first_name": "GINA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2009-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "CT2546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.