Organization Active NPI

Glens Falls Optometry PC

  • Optometrist
  • Queensbury, NY
National Provider Identifier
1003958307
Registry record updated Jun 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV006683 Issued in NY
Legal business name
GLENS FALLS OPTOMETRY PC
Practice address
357 Bay Rd
Suite #6
Queensbury, NY 12804-3050
Phone
(518) 792-3304
Fax
(518) 792-3307
NPI assigned
Feb 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Ryan Wiliam Winters, O.D.NPI 1598702185
Title
Optometrist
Phone
(518) 792-3304

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X TUV006683 NY Primary

Addresses

Primary practice location

357 Bay Rd
Suite #6
Queensbury, NY 12804-3050

Mailing address

357 Bay Rd
Suite #6
Queensbury, NY 12804-3050
Phone (518) 792-3304

Other identifiers 1

IdentifierTypeStateIssuer
1003958307OtherNYRAILROAD MEDICARE

Other names 1

  • Glens Falls Vision Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090819000645 NY Part B Supplier - Clinic/Group Practice 7214081686 Receives reassigned benefits from 2 practitioners
Practice locations: Queensbury, NY

National Provider Directory

National Provider Directory

Locations

357 Bay Rd
Ste 6
Queensbury, NY 12804
Phone (518) 792-3304

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276128000000",
    "number": "1003958307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "357 BAY RD",
            "address_2": "SUITE #6",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128043050",
            "telephone_number": "518-792-3304",
            "fax_number": "518-792-3307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "357 BAY RD",
            "address_2": "SUITE #6",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128043050",
            "telephone_number": "518-792-3304",
            "fax_number": "518-792-3307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENS FALLS OPTOMETRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2010-06-10",
        "status": "A",
        "authorized_official_last_name": "WINTERS",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "WILIAM",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "518-792-3304",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "1003958307",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glens Falls Vision Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Queensbury, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.