NPIMap

Organization Active NPI

Stamford Ophthalmology, LLC

  • Ophthalmology Physician
  • Stamford, CT
National Provider Identifier
1962632661
Registry record updated Mar 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
030718 Issued in CT
Legal business name
STAMFORD OPHTHALMOLOGY, LLC
Practice address
1351 Washington Blvd 101
Stamford, CT 06902
Phone
(203) 327-5808
Fax
(203) 352-5199
NPI assigned
Jul 16, 2009
Last updated
Mar 22, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2018

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

Authorized official

Name
Elizabeth Siderides, MDNPI 1134203953
Title
Owner
Phone
(203) 327-5808

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193200000X MULTI-SPECIALTY GROUP 156FX1800X 001612 CT
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X 030718 CT Primary

Addresses

Primary practice location

1351 Washington Blvd 101
Stamford, CT 06902

Mailing address

1351 Washington Blvd 101
Stamford, CT 06902
Phone (203) 327-5808

National Provider Directory

National Provider Directory
Tax ID family
Stamford Ophthalmology2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1351 Washington Blvd
Ste 101
Stamford, CT 06902
Phone (203) 325-0805

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1247702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521676800000",
    "number": "1962632661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 WASHINGTON BLVD 101",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "06902",
            "telephone_number": "203-327-5808",
            "fax_number": "203-352-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 WASHINGTON BLVD 101",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "06902",
            "telephone_number": "203-327-5808",
            "fax_number": "203-352-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAMFORD OPHTHALMOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-16",
        "last_updated": "2018-03-22",
        "status": "A",
        "authorized_official_last_name": "SIDERIDES",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-327-5808",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "CT",
            "license": "001612",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "CT",
            "license": "030718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; 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.