PETER PEGOLO (NPI# 1184733255) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184733255 |
| Entity Type | Individual |
| Full Name | PETER PEGOLO |
| Credential | OD |
| Practice Address |
612 Quaker Ln S Suite B West Hartford CT 06110-1027 |
| Practice Telephone | 8602361218 |
| Practice Fax Number | 8602319298 |
| Mailing Telephone | 8602361218 |
| Mailing Fax Number | 8602319298 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2012-07-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | CT02448 | CT | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD | 090002448CT02 | 01 | |
| CONNECTICARE | 002448 | 01 | |
| AETNA | 5094583 | 01 | |
| UNITED HEALTH CARE | 203912450 | 01 | |
| CIGNA | 1749886 | 01 | |
| HEALTH NET | 2V5586 | 01 | |
| TRICARE | 522108187187 | 01 | |
| VISION SERVICE PLAN | 203912450 | 01 |
| Street Address |
612 QUAKER LN S SUITE B |
| City | WEST HARTFORD |
| State | CT |
| Zip Code | 06110-1027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306467030 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 1500 New Britain Ave, H216, West Hartford, CT 06110 | 2020-05-05 |
| 1962903492 | Mitchell Graham | Chiropractor | 121 Talcott Rd, West Hartford, CT 06110 | 2018-02-21 |
| 1417302829 | Kaitlyn Roggi | Behavioral Analyst | 101 South St Fl 2, West Hartford, CT 06110 | 2016-05-04 |
| 1487036802 | Nino Gigauri | Internal Medicine | 114 Woodlawn St, Hartford, CT 06110 | 2015-06-22 |
| 1093082174 | Shital Makati | Pharmacist | 940 South Quaker Lane, West Hartford, CT 06110 | 2011-11-17 |
| 1376842948 | Kenneth Reeve | Pediatrics | 1459a New Britain Ave, West Hartford, CT 06110 | 2011-03-22 |
| 1225368913 | Jenny Alzate Lpc LLC | Counselor | 78 Cambridge St, West Hartford, CT 06110 | 2010-01-04 |
| 1821200957 | Advocate Community Care Agency, Inc. | Home Delivered Meals | 1086 New Britain Ave, West Hartford, CT 06110 | 2007-05-03 |
| 1730257155 | Catherine Ann Staunton | Physical Therapist | 1350 Chapel Street, New Haven, CT 06110 | 2006-12-01 |
| 1689750002 | Pamela M Matuszewski | Optometrist | 1445 New Britain Ave, W Hartford, CT 06110 | 2006-10-27 |
| Find all providers in zip 06110 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174926653 | Crystal Vision West Hartford LLC. | Optometrist | 64 Raymond Rd, Suite170, West Hartford, CT 06107-2213 | 2014-09-29 |
| 1457696270 | Afua Wirekoa Antwi | Optometrist | 262 Park Rd, West Hartford, CT 06119-2018 | 2012-12-05 |
| 1215229273 | Nicole Colasurdo | Optometrist | 612b Quaker Ln S, West Hartford, CT 06110-1027 | 2011-05-10 |
| 1619064169 | Roger R Hirons | Optometrist | 24 Kane St, West Hartford, CT 06119-2109 | 2006-10-06 |
| 1417967324 | Neil William Kemp | Optometrist | 1138 New Britain Ave, West Hartford, CT 06110-2413 | 2006-08-09 |
| 1154311801 | Charlene Marie Chateauneuf | Optometrist | 1013 Farmington Ave, West Hartford, CT 06107-2106 | 2005-10-25 |
| 1285257410 | Lauren Diaferio | Optometrist | 1013 Farmington Ave, West Hartford, CT 06107-2181 | 2020-05-21 |
| 1396388179 | Brittany Strebig | Optometrist | 262 Park Rd, West Hartford, CT 06119-2018 | 2019-10-23 |
| 1992347181 | Jessica Laynne Fowler | Optometrist | 1013 Farmington Ave, West Hartford, CT 06107-2181 | 2019-10-09 |
| 1285158162 | Raymond R Guimond | Optometrist | 1013 Farmington Ave, West Hartford, CT 06107-2181 | 2017-08-01 |
| Find all providers in WEST HARTFORD | ||||
| City | WEST HARTFORD |
| Zip Code | 06110 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.