Individual provider Active NPI

Martha Maietta, O.D.

  • Optometrist
  • New Britain, CT
National Provider Identifier
1942309380
Registry record updated Jul 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
02123 Issued in CT
Practice address
14 Vine St
New Britain, CT 06052-1431
Phone
(860) 229-1905
Fax
(860) 826-7292
NPI assigned
Sep 22, 2006
Last updated
Jul 21, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 02123 CT Primary
Optometrist 152W00000X 002123 CT

Addresses

Primary practice location

14 Vine St
New Britain, CT 06052-1431

Mailing address

30 Vine St
New Britain, CT 06052-1431
Phone (860) 229-1905

Other identifiers 1

IdentifierTypeStateIssuer
004112306MedicaidCT

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
I20120227000744 CT Practitioner - Optometry 8628262839 Practice locations: New Britain, CT

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

30 Vine St
New Britain, CT 06052-1431
Phone (860) 229-1905

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
02123CTMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1942309380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 VINE ST",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060521431",
            "telephone_number": "860-229-1905",
            "fax_number": "860-826-7292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 VINE ST",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060521431",
            "telephone_number": "860-229-1905",
            "fax_number": "860-826-7292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIETTA",
        "first_name": "MARTHA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "02123",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "002123",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004112306",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Britain, CT

Sources for this page

Verify at the official NPI Registry.