4D OPTOMETRY, LLC — NPI 1215376967 (Licensed & Credentialed Eye and Vision Service Providers — Optometrist, Vision Therapy in CROMWELL, CT)

CMS-1500 Box 24J / 33a • NPI

1215376967

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

152WV0400X (CMS 41)

Licensed & Credentialed Eye and Vision Service Providers — Optometrist, Vision Therapy

Box 32 Service Location & ZIP+4

181 SHUNPIKE RD, CROMWELL, CT, 06416-1143

✓ 9-Digit EDI 837 ZIP+4 (06416-1143)

Practice Phone & Referral Fax

(860) 632-8423

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1215376967 (4D OPTOMETRY, LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1215376967` (NPI-2 Organization / Facility)
Provider / Legal Name	4D OPTOMETRY, LLC
Plain-English Specialty	Licensed & Credentialed Eye and Vision Service Providers — Optometrist, Vision Therapy NUCC Code: `152WV0400X` (Optometrist, Vision Therapy)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	181 SHUNPIKE RD, CROMWELL, CT, 06416-1143
Practice Telephone / Fax	Tel: (860) 632-8423
Administrative Mailing Address	181 SHUNPIKE RD, CROMWELL, CT, 06416-1143
Enumeration & Last Sync	Enumerated: 2013-06-17 \| CMS Record Updated: 2013-06-17
Authorized Official	JUANITA COLLIER (Optometrist)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

181 SHUNPIKE RD, CROMWELL, CT, 06416-1143

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Plain-English Taxonomy & CMS Crosswalk (152WV0400X)

What Does Taxonomy Code 152WV0400X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 152WV0400X translates to:
"Licensed & Credentialed Eye and Vision Service Providers — Optometrist, Vision Therapy"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 41 (Optometry)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Optometrist, Vision Therapy for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (4D OPTOMETRY, LLC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`152WV0400X` — Optometrist, Vision Therapy Plain English: Licensed & Credentialed Eye and Vision Service Providers — Optometrist, Vision Therapy	State: CT \| License: `2779` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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4D OPTOMETRY, LLC (NPI #1215376967)