Active NPI
Mary Susan Napoleon, M.D.
- Ophthalmology Physician
- Newark, NY
National Provider Identifier
1003812454
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 145955
- Practice address
- 1210 Driving Park Ave
Newark, NY 14513-1057 - Phone
- (315) 331-8921
- Fax
- (315) 331-8231
- NPI assigned
- Jun 21, 2005
- Last updated
- Jul 9, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 145955 | NY | Primary |
Addresses
Primary practice location
1210 Driving Park Ave
Newark, NY 14513-1057
Mailing address
1210 Driving Park Ave
Newark, NY 14513-1057
Phone (315) 331-8921
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00711211 | Medicaid | NY | |
| 102386CR | Other | NY | PREFERRED CARE |
| 0070649 | Other | NY | GHI |
| 770140 | Other | NY | MVP |
| 040426005030 | Other | NM | FIDELS CARE |
| 6742 | Other | NY | BLUE CROSS/BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1003812454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1210 DRIVING PARK AVE",
"city": "NEWARK",
"state": "NY",
"postal_code": "145131057",
"telephone_number": "315-331-8921",
"fax_number": "315-331-8231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1210 DRIVING PARK AVE",
"city": "NEWARK",
"state": "NY",
"postal_code": "145131057",
"telephone_number": "315-331-8921",
"fax_number": "315-331-8231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAPOLEON",
"first_name": "MARY SUSAN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-21",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "NY",
"license": "145955",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00711211",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CARE",
"identifier": "102386CR",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "0070649",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "770140",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIDELS CARE",
"identifier": "040426005030",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "6742",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newark, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.