Organization Active NPI

Inclima Eye Care, LLC

  • Optometrist
  • West Haven, CT
National Provider Identifier
1821166703
Registry record updated Jul 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
620 Issued in CT
Legal business name
INCLIMA EYE CARE, LLC
Practice address
415 Main St
West Haven, CT 06516-4296
Phone
(203) 934-5126
Fax
(203) 932-2020
NPI assigned
Dec 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2010

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

Authorized official

Name
Dr. Christopher M Inclima, O.D.NPI 1063474575
Title
Member
Phone
(203) 934-5126

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 620 CT Primary

Addresses

Primary practice location

415 Main St
West Haven, CT 06516-4296

Mailing address

415 Main St
West Haven, CT 06516-4296
Phone (203) 934-5126

Other identifiers 1

IdentifierTypeStateIssuer
004397081MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040319000759 CT Part B Supplier - Clinic/Group Practice 8325938525 Receives reassigned benefits from 2 practitioners
Practice locations: West Haven, CT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
07D2074071Inclima Eye Care, LLC415 Main St, West Haven, CT 06516Certificate of waiverFeb 28, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279065600000",
    "number": "1821166703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MAIN ST",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065164296",
            "telephone_number": "203-934-5126",
            "fax_number": "203-932-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MAIN ST",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065164296",
            "telephone_number": "203-934-5126",
            "fax_number": "203-932-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INCLIMA EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2010-07-14",
        "status": "A",
        "authorized_official_last_name": "INCLIMA",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "203-934-5126",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CT",
            "license": "620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004397081",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.