Individual provider Active NPI

Edward A Pulice, M.D.

  • Ophthalmology Physician
  • Bridgeport, CT
National Provider Identifier
1922005800
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
22265 Issued in CT
Practice address
2720 Main St FL 3
Bridgeport, CT 06606-5363
Phone
(203) 576-6500
Fax
(203) 576-0035
NPI assigned
Jul 7, 2005
Last updated
Jan 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 22265 CT Primary
Ophthalmology Physician 207W00000X 022265 CT

Addresses

Primary practice location

2720 Main St FL 3
Bridgeport, CT 06606-5363

Mailing address

2720 Main St FL 3
Bridgeport, CT 06606-5363
Phone (203) 576-6500

Other identifiers 1

IdentifierTypeStateIssuer
001222652MedicaidCT

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091109000019 CT Practitioner - Ophthalmology 7810035177 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
22265CTMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vincent a Manjoney Jr MD PastSince Sep 5, 2023 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: epulice@manjoneyeye.emadirect.md

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1922005800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 MAIN ST FL 3",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066065363",
            "telephone_number": "203-576-6500",
            "fax_number": "203-576-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 MAIN ST FL 3",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066065363",
            "telephone_number": "203-576-6500",
            "fax_number": "203-576-0035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULICE",
        "first_name": "EDWARD",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CT",
            "license": "22265",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CT",
            "license": "022265",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001222652",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.