Edward H. Jaccoma, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

011998 Issued in ME

Practice address

87 Grandview Ave Ste a
Waterbury, CT 06708-2523

Phone

(203) 574-2020

Fax

(203) 596-2230

NPI assigned

Dec 28, 2005

Last updated

Sep 14, 2018By 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 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NH, MA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Ophthalmology

Education

University of Vermont College of Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Corneal Consultants PAGroup PAC ID 2860396124, 3 clinicians

Bay State Excellent VisionGroup PAC ID 9133353824, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.43 of 100Reported as group

Quality

100

Improvement activities

40

Cost

78.1

Merit-based Incentive Payment System (MIPS)

Final score

91.34 of 100Reported as group

Quality

98.62

Improvement activities

40

Cost

72.96

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ejaccoma1@evelc.intellechartdirect.net

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

• Bay State Excellent Vision

  • Ophthalmology Physician
  • Malden, MA
  • NPI 1437597424
  Medicare reassignment Care Compare group NPD
• Northeast Corneal Consultants, PA

  • Ophthalmology Physician
  • Portsmouth, NH
  • NPI 1699714329
  Medicare reassignment Care Compare group NPD
• Eyesight Ophthalmic Services PLLC

  • Ophthalmology Physician
  • Portsmouth, NH
  • NPI 1073736310
  NPD

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536883200000",
    "number": "1982681367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 GRANDVIEW AVE STE A",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082523",
            "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": "87 GRANDVIEW AVE STE A",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082523",
            "telephone_number": "203-574-2020",
            "fax_number": "203-596-2230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACCOMA",
        "first_name": "EDWARD",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2018-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CT",
            "license": "56003",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "ME",
            "license": "011998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982681367",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134050099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• J & J Companions and Homemakers LLC
• J & L Medical Services
• J Dey PLLC
• Ihsan I Jabbour, M.D.
• Yasmin Jaber, MD
• Jamia J Jackson, BA
• Louis E Jackson, AS
• Thomas A. Jackson
• Suzanne Jacob-Muccino
• Mauria Jacobi

• Ophthalmology Physician in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Ophthalmology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.