Organization Active NPI

East Haven Eye Care, LLC

  • Optometrist
  • East Haven, CT
National Provider Identifier
1902164148
Registry record updated Apr 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
001045 Issued in CT
Legal business name
EAST HAVEN EYE CARE, LLC
Practice address
135 Saltonstall Pkwy
East Haven, CT 06512-2426
Phone
(203) 265-7990
Fax
(203) 265-7998
NPI assigned
Apr 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2012

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

Authorized official

Name
Dr. Marc Denigris, O.D.NPI 1487879656
Title
Optometrist, Owner
Phone
(203) 265-7990

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 001045 CT Primary

Addresses

Primary practice location

135 Saltonstall Pkwy
East Haven, CT 06512-2426

Mailing address

135 Saltonstall Pkwy
East Haven, CT 06512-2426

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120612000035 CT Part B Supplier - Clinic/Group Practice 8325202914 Receives reassigned benefits from 1 practitioner
Practice locations: Wallingford, CT

National Provider Directory

National Provider Directory

Locations

310 Terrace Ave
West Haven, CT 06516
Phone (203) 654-2100

60 Church St
#68
Yalesville, CT 06492
Phone (203) 265-2205

Practitioners & affiliated clinicians

Practitioners 1

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": "1335312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335312000000",
    "number": "1902164148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 SALTONSTALL PKWY",
            "city": "EAST HAVEN",
            "state": "CT",
            "postal_code": "065122426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 SALTONSTALL PKWY",
            "city": "EAST HAVEN",
            "state": "CT",
            "postal_code": "065122426",
            "telephone_number": "203-265-7990",
            "fax_number": "203-265-7998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST HAVEN EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-25",
        "last_updated": "2012-04-25",
        "status": "A",
        "authorized_official_last_name": "DENIGRIS",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "OPTOMETRIST, OWNER",
        "authorized_official_telephone_number": "203-265-7990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CT",
            "license": "001045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; 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.