Individual provider Active NPI

Christopher Louis Agro, O.D.

  • Optometrist
  • Enfield, CT
National Provider Identifier
1912977380
Registry record updated Mar 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
002333 Issued in CT
Practice address
149 Hazard Ave
Enfield, CT 06082-4521
Phone
(860) 749-0757
Fax
(860) 763-4335
NPI assigned
Jan 26, 2006
Last updated
Mar 10, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 002333 CT Primary

Addresses

Primary practice location

149 Hazard Ave
Enfield, CT 06082-4521

Mailing address

149 Hazard Ave
Enfield, CT 06082-4521
Phone (860) 749-0757

Other identifiers 1

IdentifierTypeStateIssuer
4129070MedicaidCT

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
I20100925000058 CT Practitioner - Optometry 4183740327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Enfield Eyecare Associates LLPGroup PAC ID 9537121488, 4 clinicians

Practice addresses (Care Compare)

149 Hazard Ave
Enfield, CT 06082-4521
Phone (860) 749-0757

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2333CTMDChiropractor
002333CTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Enfield Eyecare Associates, L.L.P. Optometrist CurrentSince Aug 31, 1993 Accepting new patients
Richard a Fichman MD PC PastSince Aug 31, 1993 Accepting new patients

Locations

149 Hazard Ave
Enfield, CT 06082
Phone (860) 649-9973

Organizations & group practices 2

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": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205107200000",
    "number": "1912977380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 HAZARD AVE",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824521",
            "telephone_number": "860-749-0757",
            "fax_number": "860-763-4335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 HAZARD AVE",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824521",
            "telephone_number": "860-749-0757",
            "fax_number": "860-763-4335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGRO",
        "first_name": "CHRISTOPHER",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2008-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "002333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4129070",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enfield, CT

Sources for this page

Verify at the official NPI Registry.