Active NPI
Leora A Berns, OD
- Optometrist
- Avon, CT
National Provider Identifier
1861595027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 002118
- Practice address
- 43 West Main Street
Avon, CT 06001 - Phone
- (860) 676-2376
- Fax
- (860) 677-0517
- NPI assigned
- Sep 6, 2006
- Last updated
- Jul 9, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 002118 | CT | Primary |
Addresses
Primary practice location
43 West Main Street
Avon, CT 06001
Mailing address
43 West Main Street
Avon, CT 06001
Phone (860) 676-2376
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 090002118CT04 | Other | CT | ANTHEM |
| T22330 | Other | VSP | |
| 1015675 | Other | CT | AETNA |
| 757076 | Other | CONNECTICARE | |
| P2542157 | Other | OXFORD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2118 | CT | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1861595027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43 WEST MAIN STREET",
"city": "AVON",
"state": "CT",
"postal_code": "06001",
"telephone_number": "860-676-2376",
"fax_number": "860-677-0517"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43 WEST MAIN STREET",
"city": "AVON",
"state": "CT",
"postal_code": "06001",
"telephone_number": "860-676-2376",
"fax_number": "860-677-0517"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERNS",
"first_name": "LEORA",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-06",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CT",
"license": "002118",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "090002118CT04",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VSP",
"identifier": "T22330",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "1015675",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONNECTICARE",
"identifier": "757076",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P2542157",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Avon, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.