Individual provider Active NPI

Justin Rapp, O.D.

  • Optometrist
  • Stamford, CT
National Provider Identifier
1992085179
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
003162 Issued in CT
Practice address
2046 W Main St Ste 2
Stamford, CT 06902-4523
Phone
(203) 869-3082
NPI assigned
Aug 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 003162 CT Primary

Addresses

Primary practice location

2046 W Main St Ste 2
Stamford, CT 06902-4523

Mailing address

2046 W Main St # 2
Stamford, CT 06902-4523
Phone (203) 861-9200

Other identifiers 1

IdentifierTypeStateIssuer
0280291MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210401002376 CT Practitioner - Optometry 2961677893 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2011
Medicare assignment
May accept Medicare assignment
Group practices
Eyecare Associates PCGroup PAC ID 2769538594, 8 clinicians

Practice addresses (Care Compare)

2600 Post Rd
Southport, CT 06890-3206
Phone (203) 255-4005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007809NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Eyecare Associates, P.C. Optometrist CurrentSince Mar 30, 2021 Accepting new patients
Ny Comprehensive Medical Wellness P.C. CurrentSince Dec 1, 2017 Accepting new patients

Locations

2600 Post Rd
Southport, CT 06890
Phone (203) 255-4005

6515 Main St
Ste 12
Trumbull, CT 06611
Phone (203) 374-2020

6515 Main St
Trumbull, CT 06611
Phone (203) 268-9114

329 E 149th St
Fl 2
Bronx, NY 10451
Phone (718) 585-5500

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1992085179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2046 W MAIN ST # 2",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069024523",
            "telephone_number": "203-861-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2046 W MAIN ST STE 2",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069024523",
            "telephone_number": "203-869-3082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAPP",
        "first_name": "JUSTIN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-19",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "003162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0280291",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.