Individual provider Active NPI

Raymond Thomas Szczepanski, O. D.

  • Optometrist
  • Orange, CT
National Provider Identifier
1912011487
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0937 Issued in CT
Practice address
185 Boston Post Rd
Orange, CT 06477-3200
Phone
(203) 795-5000
Fax
(203) 795-6685
NPI assigned
Aug 19, 2006
Last updated
Jun 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0937 CT Primary

Addresses

Primary practice location

185 Boston Post Rd
Orange, CT 06477-3200

Mailing address

PO Box 771
Orange, CT 06477-0771
Phone (203) 795-5000

Other identifiers 5

IdentifierTypeStateIssuer
004138576MedicaidCT
061148751OtherCTUNITED HEALTHCARE
774875OtherCTCONNECTICARE
090000937CT06OtherCTANTHEM B.C.B.S
OV2093OtherCTHEALTHNET

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
I20100708000035 CT Practitioner - Optometry 1557492568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

185 Boston Post Rd
Orange, CT 06477-3200
Phone (203) 795-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000937CTMDMental Health Counselor
0937CTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Connecticut, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Connecticut, LLC Optometrist CurrentSince Aug 19, 2019 Accepting new patients
Myeyedr Optometry of Connecticut, LLC Optometrist CurrentSince Aug 19, 2019 Accepting new patients
Myeyedr Optometry of Connecticut, LLC Optometrist Past Accepting new patients
Myeyedr Optometry of Connecticut, LLC Optometrist Past Accepting new patients

Locations

145 Wakelee Ave
Ansonia, CT 06401
Phone (203) 734-1686

185 Boston Post Rd
Orange, CT 06477
Phone (203) 795-3682

185 Boston Post Rd
Ste 13
Orange, CT 06477
Phone (203) 795-5000

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 5

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1912011487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 771",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064770771",
            "telephone_number": "203-795-5000",
            "fax_number": "203-795-6685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 BOSTON POST RD",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064773200",
            "telephone_number": "203-795-5000",
            "fax_number": "203-795-6685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SZCZEPANSKI",
        "first_name": "RAYMOND",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "O. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "0937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004138576",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "061148751",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "774875",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM B.C.B.S",
            "identifier": "090000937CT06",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "OV2093",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CT

Sources for this page

Verify at the official NPI Registry.