Individual provider Active NPI

Jennifer Raska, O.D.

  • Optometrist
  • West Hartford, CT
National Provider Identifier
1881008522
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2916 Issued in CT
Practice address
28 N Main St Ste 102
West Hartford, CT 06107-1992
Phone
(860) 206-3060
Fax
(959) 255-6077
NPI assigned
Jun 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2916 CT Primary

Addresses

Primary practice location

28 N Main St Ste 102
West Hartford, CT 06107-1992

Mailing address

28 N Main St Ste 102
West Hartford, CT 06107-1992
Phone (860) 206-3060

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
I20141013001560 CT Practitioner - Optometry 0547480691 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2014
Medicare assignment
May accept Medicare assignment
Group practices
Envision 2020 Eyecare, LLCGroup PAC ID 8527493030, 4 clinicians

Practice addresses (Care Compare)

28 N Main St
West Hartford, CT 06107-1992
Phone (631) 848-8126

380 W Main St
Avon, CT 06001-3690
Phone (860) 409-4565

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2916CTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Envision 2020 Eyecare, LLC Optometrist CurrentSince Nov 1, 2024 Accepting new patients
Avon Eye Associates LLC Optometrist CurrentSince Nov 10, 2024 Accepting new patients
Eye Disease Consultants, LLC Optometrist CurrentSince Aug 1, 2017 Accepting new patients
Central Eye Care, LLC Optometrist CurrentSince Feb 1, 2025 Accepting new patients
Prohealth Physicians PC PastSince Aug 1, 2017 Accepting new patients

Locations

40 Avon Meadow Ln
Avon, CT 06001
Phone (860) 677-6444

380 W Main St
Avon, CT 06001
Phone (860) 409-4565

28 N Main St
Ste 102
West Hartford, CT 06107
Phone (631) 848-8126

1043 Farmington Ave
West Hartfrd, CT 06107
Phone (860) 521-1611

Organizations & group practices 6

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": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1881008522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 N MAIN ST STE 102",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061071992",
            "telephone_number": "860-206-3060",
            "fax_number": "959-255-6077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 N MAIN ST STE 102",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061071992",
            "telephone_number": "860-206-3060",
            "fax_number": "959-255-6077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASKA",
        "first_name": "JENNIFER",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-19",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "2916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

Verify at the official NPI Registry.