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DR. JAMES ARTHUR SANBORN O.D.
NPI 1558619544
Optometrist in Gales Ferry, CT

Active since August 22, 2012PECOS EnrolledAccepts Medicare Assignment
1 INCHCLIFFE DR, GALES FERRY, CT 06335(860) 445-4412(860) 449-0343 Get Directions Write a Review

NPPES record last updated: February 2, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Feb 2, 2026, Jan 2, 2026, May 18, 2022 and 2 more (5 updates tracked since 2016).

About Dr. James Arthur Sanborn O.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JAMES ARTHUR SANBORN O.D. (NPI 1558619544) is an individual optometrist in Gales Ferry, Connecticut, licensed in Connecticut (002879) and active in the NPI registry since August 2012. He is enrolled in Medicare PECOS and is a graduate of New England College Of Optometry (2012).

NPPES Registry Identity

NPI1558619544
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. JAMES ARTHUR SANBORNCredential: O.D.
Location Address1 INCHCLIFFE DRGales Ferry, CT 06335-1807
Mailing Address1 Inchcliffe DrGales Ferry, CT 06335-1807 · (860) 445-4412 · Fax (860) 449-0343
Phone(860) 445-4412
Fax(860) 449-0343
Sole ProprietorNo
Medical School CMSNew England College Of OptometryGraduated 2012
Enumeration DateAugust 22, 2012
Last NPPES UpdateFebruary 2, 20265 updates tracked since enumeration
NPPES CertifiedFebruary 2, 2026
✔ NPI 1558619544 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in CT · 002879
Definition
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.
1 INCHCLIFFE DR, Gales Ferry, CT 06335
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. James Arthur Sanborn O.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4880822659
PECOS Enrollment IDI20140124001793
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show James Sanborn reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Sanborn Eye Care
Same address
Optometrist
1 INCHCLIFFE DR
Gales Ferry, CT 06335
  • Reassigned Medicare billing, Connecticut enrollment
  • 2 clinicians in this Medicare group
NPI 1578009973 (860) 445-4412
Professional Eyecare, LLC
5.6 mi
Optometrist
131 BOSTON POST RD, SUITE 4
Waterford, CT 06385
  • Reassigned Medicare billing, Connecticut enrollment
  • 5 clinicians in this Medicare group
NPI 1538396080 (860) 442-5058

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
85 services84 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
49 services32 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
46 services46 patients
Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
41 services35 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
37 services19 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06335 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$138.84 typical visit price
range $60.82 – $183.10
Typical copayment $34.71 (range $15.20 – $45.77)
Most-billed visit code 99204
Established Patient
$75.55 typical visit price
range $19.76 – $149.26
Typical copayment $18.88 (range $4.94 – $37.31)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. MARIE ANTOINTEET HEALY L. AC., MSOM
Acupuncturist
1 INCHCLIFFE DR, SUITE D
GALES FERRY, CT 06335
Southeastern Connecticut Planning Region (860) 908-7078
SANBORN EYE CARE
Optometrist
1 INCHCLIFFE DR
GALES FERRY, CT 06335
Southeastern Connecticut Planning Region (860) 445-4412
MEGHAN E LAMOUREUX O.D.
Optometrist
1 INCHCLIFFE DR
GALES FERRY, CT 06335
Southeastern Connecticut Planning Region (860) 445-4412

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is James Sanborn's NPI number?

The NPI number for James Sanborn is 1558619544. It was assigned to this individual provider in the NPPES registry on August 22, 2012.

Where is James Sanborn located?

James Sanborn practices at 1 Inchcliffe Dr, Gales Ferry, CT 06335. The listed phone number is (860) 445-4412.

What is James Sanborn's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is James Sanborn enrolled in Medicare?

Yes. James Sanborn is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for James Sanborn's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Sanborn reassigns Medicare benefits to 2 organizations: Sanborn Eye Care (Gales Ferry, CT) and Professional Eyecare, LLC (Waterford, CT). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for James Sanborn's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Sanborn accept?

Health plans from Anthem Blue Cross and Blue Shield list James Sanborn as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for James Sanborn was last updated on February 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.