DR. LANCE CALL LYSIUK (NPI# 1366450041) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366450041 |
| Entity Type | Individual |
| Full Name | DR. LANCE CALL LYSIUK |
| Credential | OD |
| Practice Address |
438 Main St Suite 204 Middletown CT 06457-3396 |
| Mailing Address |
888 Worcester St Suite 130 Wellesley MA 02482-3744 |
| Practice Telephone | 8889646681 |
| Practice Fax Number | 8886620859 |
| Mailing Telephone | 6179646681 |
| Mailing Fax Number | 3396862561 |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2014-10-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 002499 | CT | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | BLUE CROSS BLUE SHIELD | 090002499CT01 | 01 |
| CT | MEDICARE RAILROAD | 410038928 | 01 |
| CT | 004189868 | 05 |
| Street Address |
438 MAIN ST SUITE 204 |
| City | MIDDLETOWN |
| State | CT |
| Zip Code | 06457-3396 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316489636 | Nicole Adams | Dental Hygienist | 438 Main St, Suite 204, Middletown, CT 06457-3396 | 2016-11-17 |
| 1528516614 | Colleen Bouffard | Dental Hygienist | 438 Main St, Suite 204, Middletown, CT 06457-3396 | 2016-09-17 |
| 1962855106 | Christina Bearish | Dental Hygienist | 438 Main St, Suite 204, Middletown, CT 06457-3396 | 2016-07-22 |
| 1275942054 | Mary Shepard | Dental Hygienist | 438 Main St, Suite 204, Middletown, CT 06457-3396 | 2014-08-06 |
| 1003233149 | Terri Davis | Dental Hygienist | 438 Main St, Suite 204, Middletown, CT 06457-3396 | 2014-03-26 |
| 1003246042 | Deanna Dennis | Dental Hygienist | 438 Main St, Suite 204, Middletown, CT 06457-3397 | 2013-11-12 |
| 1114353802 | Kathryn Merry Tiedy | Audiologist | 438 Main St, Suite 204, Middletown, CT 06457-3396 | 2013-09-25 |
| 1063750396 | Jessica Rivera | Technician/Technologist | 438 Main St, Suite 204, Middletown, CT 06457-3396 | 2013-01-22 |
| 1013249895 | Paula Kay Mclaughlin | Audiologist | 438 Main St, Suite 204, Middletown, CT 06457-3396 | 2010-02-04 |
| 1821250952 | Eric John Pape | Optometrist | 438 Main St, Suite 204, Middletown, CT 06457-3396 | 2008-06-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699391961 | Meghan Harrington | Behavior Technician | 101 Centerpoint Drive #243, Middletown, CT 06457 | 2020-06-22 |
| 1427619626 | Collaborative Aba Services, LLC | Behavioral Analyst | 515 Centerpoint Drive, Suite 205, Middletown, CT 06457 | 2019-06-27 |
| 1376100339 | Kimberly Tynik | Pharmacist | 451 Fowler Ave, Middletown, CT 06457 | 2019-05-24 |
| 1184101263 | Tabrez Adil | Dentist | 675 Main St., Middletown, CT 06457 | 2018-07-23 |
| 1326535337 | Rehan Khan | Non-emergency Medical Transport (VAN) | 765 Country Club Rd, Middletown, CT 06457 | 2018-04-16 |
| 1366950206 | State of Connecticut | Psychiatric Hospital | 70 O'brien Drive, Middletown, CT 06457 | 2018-01-12 |
| 1902324536 | Cynthia Tine | Physical Therapy Assistant | 628 Congdon Street, Middletown, CT 06457 | 2017-09-04 |
| 1619494390 | Nathan Douglas Roy | Specialist/Technologist | 431 Briarwood Lane, Middletown, CT 06457 | 2017-08-24 |
| 1598286502 | Rachel Hoffman Whelen | Registered Nurse | 420 Saybrook Road, Suite A, Middletown, CT 06457 | 2017-06-29 |
| 1003358326 | Rebecca Rotondo | Social Worker | 230 Main Street Extension, Act Team, Gilead Community Services, Middletown, CT 06457 | 2016-11-17 |
| Find all providers in zip 06457 | ||||
| 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 |
|---|---|---|---|---|
| 1205453008 | Hanke Optometry | Optometrist | Hanke Optometry, 2900 Towne Blvd, Middletown, OH 45044-6200 | 2020-06-29 |
| 1790342301 | Linh-an Nguyen | Optometrist | 5850 Innovation Dr, Middletown, OH 45005-5188 | 2019-05-20 |
| 1184133605 | Stella C Ohanenye Od LLC | Optometrist | 600 N Broad St Ste 12, Middletown, DE 19709-1032 | 2017-09-27 |
| 1902256332 | Alicia Zhou | Optometrist | 3600 Towne Blvd Ste B, Middletown, OH 45005-5543 | 2016-06-16 |
| 1518375260 | Tara E Yerkes | Optometrist | 472 E Main St, Suite 472-474, Middletown, DE 19709-1462 | 2014-07-25 |
| 1679860753 | Eric T. Combs | Optometrist | 1015 Summitt Dr, Middletown, OH 45042-3464 | 2011-07-08 |
| 1417139817 | Vz Optical Corp | Optometrist | 1 Galleria Dr Ste 128, Middletown, NY 10941-3028 | 2007-11-28 |
| 1700088481 | Grace Matos | Optometrist | One North Galleria Drive, Middletown, NY 10941 | 2007-06-04 |
| 1710016639 | Halpern Eye Associates, P.a. | Optometrist | 223 - E Main St., Middletown, DE 19709-1449 | 2007-03-05 |
| 1205974250 | Kirsten M Healey | Optometrist | 811 Aquidneck Ave, Middletown, RI 02842-5256 | 2007-02-02 |
| Find all providers in MIDDLETOWN | ||||
| City | MIDDLETOWN |
| Zip Code | 06457 |
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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.