Katharina Ernst-Sixto, LICENSED OPTICIAN

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

001623 Issued in CT

Practice address

495 Hawley LN
Stratford, CT 06614-1514

Phone

(203) 375-5819

Fax

(203) 377-4337

NPI assigned

Jan 3, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1514937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1962919605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 HAWLEY LN",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066141514",
            "telephone_number": "203-375-5819",
            "fax_number": "203-377-4337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 HAWLEY LN",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066141514",
            "telephone_number": "203-375-5819",
            "fax_number": "203-377-4337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERNST-SIXTO",
        "first_name": "KATHARINA",
        "name_prefix": "Mrs.",
        "credential": "LICENSED OPTICIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-03",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "CT",
            "license": "001623",
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "CT",
            "license": "001623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114438652",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Eyewear Supplier in Stratford, CT
• Providers in Stratford, CT by specialty
• Eyewear Supplier in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.