Douglas P Agranov, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

000703 Issued in CT

Practice address

749 Boston Post Rd
Madison, CT 06443-3044

Phone

(203) 245-1492

Fax

(203) 245-9002

NPI assigned

Apr 7, 2006

Last updated

Feb 12, 2010By 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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265932800000",
    "number": "1952364465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 GRANDVIEW AVE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082514",
            "telephone_number": "203-574-2020",
            "fax_number": "203-596-2230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "749 BOSTON POST RD",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064433044",
            "telephone_number": "203-245-1492",
            "fax_number": "203-245-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGRANOV",
        "first_name": "DOUGLAS",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2010-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "000703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004023701",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.