Active NPI
Peter T. Krenicky MD PC
- Ophthalmology Physician
- East Hartford, CT
National Provider Identifier
1982914354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 013523
- Legal business name
- PETER T. KRENICKY MD PC
- Practice address
- 477 Connecticut Blvd.
Suite 205
East Hartford, CT 06108 - Phone
- (860) 528-9645
- Fax
- (860) 528-6366
- NPI assigned
- Oct 19, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Peter T Krenicky, M.D.
- Title
- Principle
- Phone
- (860) 528-9645
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 013523 | CT | Primary |
Addresses
Primary practice location
477 Connecticut Blvd.
Suite 205
East Hartford, CT 06108
Mailing address
477 Connecticut Blvd.
Suite 205
East Hartford, CT 06108
Phone (860) 528-9645
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001135235 | Medicaid | CT | |
| 010013529CT | Other | CT | BCBS OF CT |
| 298521 | Other | CT | WELLCARE |
| 013523 | Other | CT | CONNETICARE |
| 117584 | Other | CT | EYEMED |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287446400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1287446400000",
"number": "1982914354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "477 CONNECTICUT BLVD.",
"address_2": "SUITE 205",
"city": "EAST HARTFORD",
"state": "CT",
"postal_code": "06108",
"telephone_number": "860-528-9645",
"fax_number": "860-528-6366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "477 CONNECTICUT BLVD.",
"address_2": "SUITE 205",
"city": "EAST HARTFORD",
"state": "CT",
"postal_code": "06108",
"telephone_number": "860-528-9645",
"fax_number": "860-528-6366"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PETER T. KRENICKY MD PC",
"organizational_subpart": "NO",
"enumeration_date": "2010-10-19",
"last_updated": "2010-10-19",
"status": "A",
"authorized_official_last_name": "KRENICKY",
"authorized_official_first_name": "PETER",
"authorized_official_middle_name": "T",
"authorized_official_title_or_position": "PRINCIPLE",
"authorized_official_telephone_number": "860-528-9645",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": "CT",
"license": "013523",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001135235",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF CT",
"identifier": "010013529CT",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "298521",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONNETICARE",
"identifier": "013523",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EYEMED",
"identifier": "117584",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.