Ronicha Azard Lin, O.D.

Individual provider Active NPI Optometrist · Windsor, CT

NPI 1861843658 · NPPES record last updated May 25, 2021

Key facts

NPI
1861843658
Entity type
Individual (NPI type 1)
Primary specialty
Optometrist 152W00000X
License
2984 (CT)
Practice address
502 Windsor Ave
Windsor, CT 06095-4046
Phone
(860) 688-5303
Fax
(860) 688-5853
NPI assigned
Jun 23, 2016
Sex
Female
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Optometry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

502 Windsor Ave
Windsor, CT 06095-4046
Phone (860) 688-5303

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20170505000168 CT Practitioner - Optometry 1153608807 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Eye Care, LLC Optometrist Current
since Oct 25, 2016
Accepting new patients

Locations

65 Raymond Rd
West Hartford, CT 06107

502 Windsor Ave
Windsor, CT 06095
Phone (860) 688-5303

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2984 CT Yes

Addresses

Primary practice location

502 Windsor Ave
Windsor, CT 06095-4046

Mailing address

502 Windsor Ave
Windsor, CT 06095-4046
Phone (860) 688-5303

Other providers in Windsor, CT

All providers in Windsor, CT · Optometrist in Connecticut

Sources for this page

Verify at the official NPI Registry.