Individual provider Active NPI

Konstantin Fishilevich, OD

  • Optometrist
  • Milford, CT
National Provider Identifier
1902225055
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3227 Issued in CT
Practice address
202 Cherry St
Milford, CT 06460-3538
Phone
(203) 878-1236
Fax
(203) 874-8838
NPI assigned
Apr 15, 2014
Last updated
Apr 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3227 CT Primary

Addresses

Primary practice location

202 Cherry St
Milford, CT 06460-3538

Mailing address

202 Cherry St
Milford, CT 06460-3538
Phone (203) 878-1236

Other practice location 1

325 Boston Post Rd Ste 1A
Orange, CT 06477-3504
Phone (203) 795-0766

Other practice location 2

1236 Main St
Branford, CT 06405-3797
Phone (203) 488-5688

Other practice location 3

2 Trap Falls Rd Ste 104
Shelton, CT 06484-4616
Phone (203) 944-0464

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
I20220207001088 CT Practitioner - Optometry 3870800154 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Physicians and Surgeons, PCGroup PAC ID 9133161128, 11 clinicians

Practice addresses (Care Compare)

1236 Main St
Branford, CT 06405-3797
Phone (203) 488-5688

202 Cherry St
Milford, CT 06460-3502

202 Cherry St
Milford, CT 06460-3538
Phone (203) 878-1236

325 Boston Post Rd
Orange, CT 06477-3504
Phone (203) 795-0766

C/O Eye Physicians and Surgeons PC
202 Cherry Street
Milford, CT 06460-3502

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008149NYMDRegistered Dietitian
3227CTMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Physicians & Surgeons, PC Current Accepting new patients
Eye Physicians & Surgeons, PC CurrentSince Feb 1, 2022 Accepting new patients
Eye Physicians & Surgeons, PC CurrentSince Feb 1, 2022 Accepting new patients

Locations

1236 Main St
Branford, CT 06405
Phone (203) 488-5688

202 Cherry St
Milford, CT 06460
Phone (203) 876-0545

325 Boston Post Rd
Ste 1A
Orange, CT 06477
Phone (203) 795-0766

2 Trap Falls Rd
Ste 104
Shelton, CT 06484
Phone (203) 944-0464

Interoperability endpoints

  • Direct secure messaging: kfishilevich1052342@nychhc.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1902225055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 CHERRY ST",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064603538",
            "telephone_number": "203-878-1236",
            "fax_number": "203-874-8838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 CHERRY ST",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064603538",
            "telephone_number": "203-878-1236",
            "fax_number": "203-874-8838"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 Boston Post Rd Ste 1A",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CT",
            "postal_code": "064773504",
            "country_code": "US",
            "telephone_number": "203-795-0766",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1236 Main St",
            "address_purpose": "LOCATION",
            "city": "Branford",
            "state": "CT",
            "postal_code": "064053797",
            "country_code": "US",
            "telephone_number": "203-488-5688",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Trap Falls Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Shelton",
            "state": "CT",
            "postal_code": "064844616",
            "country_code": "US",
            "telephone_number": "203-944-0464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FISHILEVICH",
        "first_name": "KONSTANTIN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-15",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "3227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, CT

Sources for this page

Verify at the official NPI Registry.