NPIMap

Organization Active NPI

Matthew Blondin, Blondin Shea Eye Care

  • Optometrist
  • Torrington, CT
National Provider Identifier
1831647247
Registry record updated Apr 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MATTHEW BLONDIN, BLONDIN SHEA EYE CARE
Practice address
379 Prospect Street
Suite B
Torrington, CT 06790
Phone
(860) 489-2781
Fax
(860) 489-9017
NPI assigned
Sep 14, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2018

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

Authorized official

Name
Dr. Matthew Blondin, OD, FAAONPI 1386611762
Title
Owner
Phone
(860) 489-2781

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 000845 CT
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

379 Prospect Street
Suite B
Torrington, CT 06790

Mailing address

P.O. Box 448
379 Prospect Street, Suite B
Torrington, CT 06790
Phone (860) 489-2781

Other identifiers 1

IdentifierTypeStateIssuer
004024592MedicaidCT

Other names 1

  • Blondin Shea Eyecare Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Blondin Shea Eyecare2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1473811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523318400000",
    "number": "1831647247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 448",
            "address_2": "379 PROSPECT STREET, SUITE B",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "06790",
            "telephone_number": "860-489-2781",
            "fax_number": "860-489-9017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 PROSPECT STREET",
            "address_2": "SUITE B",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "06790",
            "telephone_number": "860-489-2781",
            "fax_number": "860-489-9017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW BLONDIN, BLONDIN SHEA EYE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-14",
        "last_updated": "2018-04-10",
        "status": "A",
        "authorized_official_last_name": "BLONDIN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-489-2781",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD, FAAO"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CT",
            "license": "000845",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004024592",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blondin Shea Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Torrington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.