Individual provider Active NPI

Jane Khorosh, O.D.

  • Optometrist
  • Westport, CT
National Provider Identifier
1942581145
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2844 Issued in CT
Practice address
877 Post Rd E
Westport, CT 06880-5242
Phone
(203) 226-5585
NPI assigned
Aug 31, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV007719-1 NY
Optometrist 152W00000X 2844 CT Primary

Addresses

Primary practice location

877 Post Rd E
Westport, CT 06880-5242

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

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
I20120315000074 CT Practitioner - Optometry 4880853597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Connecticut LLCGroup PAC ID 1557666237, 70 clinicians

Practice addresses (Care Compare)

125 Danbury Rd
Suite 8
Ridgefield, CT 06877-4111
Phone (203) 438-5005

145 Wakelee Ave
Ansonia, CT 06401-1176
Phone (203) 734-1686

877 Post Rd E
Westport, CT 06880-5242
Phone (203) 226-5585

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2844CTMDProfessional Counselor
TUV007719-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Connecticut, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Connecticut, LLC Optometrist CurrentSince Feb 1, 2016 Accepting new patients
Myeyedr Optometry of Connecticut, LLC Optometrist CurrentSince Feb 1, 2016 Accepting new patients
Myeyedr Optometry of Connecticut, LLC Optometrist Past Accepting new patients

Locations

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

87 Grandview Ave
Ste B
Waterbury, CT 06708
Phone (203) 465-1424

877 Post Rd E
Westport, CT 06880
Phone (203) 221-0545

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1942581145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 POST RD E",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068805242",
            "telephone_number": "203-226-5585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOROSH",
        "first_name": "JANE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-31",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007719-1",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "2844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westport, CT

Sources for this page

Verify at the official NPI Registry.