Organization Active NPI

Stamford Vision Care.LLC

  • Optometrist
  • Stamford, CT
National Provider Identifier
1821261801
Registry record updated Mar 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2021 Issued in CT
Legal business name
STAMFORD VISION CARE.LLC
Practice address
526 Newfield Ave
Stamford, CT 06905-3746
Phone
(203) 327-1511
Fax
(203) 325-4479
NPI assigned
Apr 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2011

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

Authorized official

Name
John P Decarlo, O.D.
Title
Optometrist
Phone
(203) 327-1511

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 704 CT
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 2021 CT Primary

Addresses

Primary practice location

526 Newfield Ave
Stamford, CT 06905-3746

Mailing address

526 Newfield Ave
Stamford, CT 06905-3746
Phone (203) 327-1511

Other identifiers 3

IdentifierTypeStateIssuer
4653930001OtherCTDME
124217OtherCTUNITED HEALTHCARE
090000704CT01OtherCTANTHEM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101206000843 CT Part B Supplier - Clinic/Group Practice 4486841277 Receives reassigned benefits from 3 practitioners
Practice locations: Stamford, CT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1207785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300147200000",
    "number": "1821261801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 NEWFIELD AVE",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069053746",
            "telephone_number": "203-327-1511",
            "fax_number": "203-325-4479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "526 NEWFIELD AVE",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069053746",
            "telephone_number": "203-327-1511",
            "fax_number": "203-325-4479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAMFORD VISION CARE.LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-10",
        "last_updated": "2011-03-15",
        "status": "A",
        "authorized_official_last_name": "DECARLO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "203-327-1511",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CT",
            "license": "704",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CT",
            "license": "2021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME",
            "identifier": "4653930001",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "124217",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "090000704CT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2011; 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.