Individual provider Active NPI

David W. Joel, O.D.

  • Optometrist
  • New Haven, CT
National Provider Identifier
1861484081
Registry record updated Aug 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
948 Issued in CT
Practice address
130 Amity Rd
New Haven, CT 06515-1405
Phone
(203) 397-3878
Fax
(203) 397-9110
NPI assigned
Aug 16, 2005
Reactivated
Mar 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 948 CT Primary
Corneal and Contact Management Optometrist 152WC0802X 948 CT

Addresses

Primary practice location

130 Amity Rd
New Haven, CT 06515-1405

Mailing address

130 Amity Rd
New Haven, CT 06515-1405
Phone (203) 397-3878

Other identifiers 1

IdentifierTypeStateIssuer
004101218MedicaidCT

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
I20101213000417 CT Practitioner - Optometry 1658568910 Reassigns benefits to 1 organization
Practice locations: New Haven, CT

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

130 Amity Rd
New Haven, CT 06515-1405
Phone (203) 397-3878

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
948CTMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
David W. Joel LLC Optometrist CurrentSince Oct 1, 2019 Accepting new patients

Locations

130 Amity Rd
New Haven, CT 06515
Phone (203) 397-3878

Organizations & group practices 1

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219276800000",
    "number": "1861484081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 AMITY RD",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065151405",
            "telephone_number": "203-397-3878",
            "fax_number": "203-397-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 AMITY RD",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065151405",
            "telephone_number": "203-397-3878",
            "fax_number": "203-397-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOEL",
        "first_name": "DAVID",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2008-08-21",
        "deactivation_date": "2006-03-22",
        "reactivation_date": "2006-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "948",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CT",
            "license": "948",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004101218",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.