OPTIMYSTIC LLC (NPI# 1679107411) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679107411 |
| Entity Type | Organization |
| Organization Name | OPTIMYSTIC LLC |
| Practice Address |
12 Roosevelt Ave Mystic CT 06355-2809 |
| Practice Telephone | 8605361313 |
| Practice Fax Number | 8605727770 |
| Mailing Telephone | 8605361313 |
| Mailing Fax Number | 8605727770 |
| Enumeration Date | 2020-03-02 |
| Last Update Date | 2020-03-24 |
| Authorized Official Name | DR. THOMAS JEFFREY WAGNER (MEMBER) |
| Authorized Official Telephone | 8605361313 |
| Authorized Official Credential | OD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | Eye and Vision Services Providers |
| Other Name | Type Code |
|---|---|
| OptiMystic Eye Group | Doing Business As Name - Organization |
| Street Address |
12 ROOSEVELT AVE |
| City | MYSTIC |
| State | CT |
| Zip Code | 06355-2809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114993789 | Thomas Jeffrey Wagner | Optometrist | 12 Roosevelt Ave, Mystic, CT 06355-2809 | 2006-02-24 |
| 1801353735 | Integrative Wellness Center, LLC | Naturopath | 12 Roosevelt Ave, Mystic, CT 06355-2809 | 2019-02-27 |
| 1972954477 | Mystic Medical Associates LLC | Counselor | 12 Roosevelt Ave, Second Floor, Mystic, CT 06355-2809 | 2016-06-27 |
| 1164896189 | Natura Medica | Naturopath | 12 Roosevelt Ave, Mystic, CT 06355-2809 | 2015-11-16 |
| 1992175038 | Ana Gabriella Ruediger | Naturopath | 12 Roosevelt Ave, Mystic, CT 06355-2809 | 2015-10-01 |
| 1669889820 | Christopher J Anderson | Nurse Practitioner | 12 Roosevelt Ave, Second Floor, Mystic, CT 06355 | 2014-07-18 |
| 1598105595 | Dialect Pyschotherapy Inc. | Marriage & Family Therapist | 12 Roosevelt Ave, Mystic, CT 06355-2809 | 2013-07-05 |
| 1205138161 | Susanne G Taylor | Marriage & Family Therapist | 12 Roosevelt Ave, Mystic, CT 06355-2809 | 2010-11-29 |
| 1174853691 | Anne Rivers | Social Worker | 12 Roosevelt Ave, Suite 203, Mystic, CT 06355-2809 | 2010-01-06 |
| 1548449119 | Deirdre J. O'connor, N.d. | Naturopath | 12 Roosevelt Ave, Mystic, CT 06355-2809 | 2007-10-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770076069 | Brian Kristofer Owczarski | Physical Therapist | 80 Stonington Rd Ste A-3, Mystic, CT 06355 | 2018-06-11 |
| 1922554120 | Kayla Nickerson Gauthier | Marriage & Family Therapist | 41 Williams Ave, Mystic, CT 06355 | 2016-08-28 |
| 1417351156 | Lisa Pacifico | Physical Therapist | 44 Maritime Dive, Mystic, CT 06355 | 2014-10-09 |
| 1619386539 | Jennifer Rock | Occupational Therapist | 44 Maritime Drive, Pendleton Health and Rehab Center, Mystic, CT 06355 | 2014-08-05 |
| 1346565843 | Karen Lucille Hanscom | Psychologist | 47 Water St. #203, Mystic, CT 06355 | 2010-03-29 |
| 1346415627 | Eldon Richard Kilpatrick | Physical Therapy Assistant | 186 Jerry Browne Rd, Mystic, CT 06355 | 2008-04-28 |
| 1760688931 | Heather Elyse Geyer | Physical Therapist | 2440 Gold Star Hwy Suite 201, Mystic, CT 06355 | 2007-06-25 |
| 1982728754 | Falck Eye Center LLC | Ophthalmology | 35 Washington Street, Mystic, CT 06355 | 2007-03-19 |
| 1881724326 | Richard Irwin Steinberg | Dentist | 117 Cow Hill Road, Mystic, CT 06355 | 2007-03-06 |
| 1992890362 | Coastal Dermatology, P.C. | Dermatology | 55 Willow Street, Mystic, CT 06355 | 2006-10-03 |
| Find all providers in zip 06355 | ||||
| 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 |
|---|---|---|---|---|
| 1023449477 | Totalvision Eye Health Center, LLC | Optometrist | 12 Coogan Blvd, Mystic, CT 06355-1938 | 2013-12-11 |
| 1114993789 | Thomas Jeffrey Wagner | Optometrist | 12 Roosevelt Ave, Mystic, CT 06355-2809 | 2006-02-24 |
| 1770750010 | Wagner Industries, Inc. | Optometrist | 5 Water St, C/o Optimystic, Mystic, CT 06355-2507 | 2008-05-15 |
| 1942480660 | Visions Sight & Learning Center | Optometrist | 23 Clara Drive, Mystic, CT 06355-1959 | 2007-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225638463 | Troy Sanfilippo | Optometrist | 286 Laurelwood Dr, Salem, CT 06420-3937 | 2020-10-27 |
| 1205434347 | Mvca | Optometrist | Navy Submarine Base New London, Bldg 484, Groton, CT 06349 | 2020-10-12 |
| 1588279590 | Eyes On Nigrelli, LLC | Optometrist | 18 Pennsylvania Ave, Niantic, CT 06357-3231 | 2020-09-15 |
| 1558973289 | Solinsky Eyecare LLC | Optometrist | 55 Nye Rd Ste 104, Glastonbury, CT 06033-1281 | 2020-08-24 |
| 1528670783 | Irene Elaine Antar | Optometrist | 152 Merrow Rd #23c, Tolland, CT 06084 | 2020-08-19 |
| 1750991345 | Connecticut Children's Eye Care, P.C. | Optometrist | 599 Farmington Ave Ste 201, Farmington, CT 06032-2356 | 2020-08-07 |
| 1013525302 | Eyeconic Vision Care LLC | Optometrist | 500 Andrews Way Apt 102, South Windsor, CT 06074-9601 | 2020-07-22 |
| 1295351104 | Victor Paul | Optometrist | 1920 Norwich New London Tpke, Uncasville, CT 06382-1384 | 2020-06-17 |
| 1700410727 | Optimized Vision & Eye Care LLC | Optometrist | 20 Division St, Derby, CT 06418-1430 | 2020-02-28 |
| 1346871423 | Clarivision-advanced Eye Care | Optometrist | 40 Black Rock Turnpike, Fairfield, CT 06825 | 2020-01-28 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on OPTIMYSTIC LLC.
| 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.