Brian G Mann, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2229 Issued in CT

Practice address

909 Hartford Tpke
Unit D2
Waterford, CT 06385-4267

Phone

(860) 442-0380

Fax

(860) 442-0831

NPI assigned

Sep 25, 2006

Last updated

Dec 17, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

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

Specialty

Optometry

Education

New England College of Optometry, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Crystal Vision, LLCGroup PAC ID 2466525043, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Crystal Vision, LLC

  dba Pearle Vision

  • Optometrist
  • Waterford, CT
  • NPI 1760556393
  Medicare reassignment Care Compare group Authorized official
• Crystal Vision West Hartford LLC.

  • Optometrist
  • West Hartford, CT
  • NPI 1174926653
  Authorized official Same address or phone

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229472000000",
    "number": "1942301858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 HARTFORD TPKE",
            "address_2": "UNIT D2",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063854267",
            "telephone_number": "860-442-0380",
            "fax_number": "860-442-0831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 HARTFORD TPKE",
            "address_2": "UNIT D2",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063854267",
            "telephone_number": "860-442-0380",
            "fax_number": "860-442-0831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "BRIAN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2008-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "2229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P462855",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "0V2114",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "090002229CT02",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "564723",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "8744282",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mari Jo Macinnis, LMFT
• John Ross Mackinnon, PH.D.
• Melissa T Mahar, MS,RPH
• Noha Maklad
• Frank William Maletz, M.D.
• Karen Marquardt
• Urielle Marseille, MD
• Michael C Marshall, LCSW
• Martin L Hellman, OD, Faao, LLC
• Martin L Hellman, OD, Faao, LLC

• Optometrist in Waterford, CT
• Providers in Waterford, CT by specialty
• Optometrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.