Organization Active NPI

Meriden Eye Care, LLC

  • Optometrist
  • Meriden, CT
National Provider Identifier
1841674520
Registry record updated Jul 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
002821 Issued in CT
Legal business name
MERIDEN EYE CARE, LLC
Practice address
816 Broad St
Ste 13
Meriden, CT 06450-4350
Phone
(203) 237-2020
Fax
(203) 237-2040
NPI assigned
Jul 13, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2015

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

Authorized official

Name
Dr. Maria Luiza Gheorghe-Youssefi, O.D.NPI 1861565426
Title
Owner
Phone
(312) 622-0709

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 002821 CT Primary

Addresses

Primary practice location

816 Broad St
Ste 13
Meriden, CT 06450-4350

Mailing address

816 Broad St
Ste 13
Meriden, CT 06450-4350
Phone (203) 237-2020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151203000650 CT Part B Supplier - Clinic/Group Practice 8820398456 Receives reassigned benefits from 3 practitioners
Practice locations: Meriden, CT

National Provider Directory

National Provider Directory

Locations

816 Broad St
Ste 13
Meriden, CT 06450
Phone (203) 237-2020

658 Broad St
Meriden, CT 06450
Phone (203) 237-2020

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": "1436745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436745600000",
    "number": "1841674520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 BROAD ST",
            "address_2": "STE 13",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064504350",
            "telephone_number": "203-237-2020",
            "fax_number": "203-237-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 BROAD ST",
            "address_2": "STE 13",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064504350",
            "telephone_number": "203-237-2020",
            "fax_number": "203-237-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDEN EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-13",
        "last_updated": "2015-07-13",
        "status": "A",
        "authorized_official_last_name": "GHEORGHE-YOUSSEFI",
        "authorized_official_first_name": "MARIA LUIZA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-622-0709",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CT",
            "license": "002821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meriden, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2015; 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.