Individual provider Active NPI

Jessica Rauch, O.D.

  • Optometrist
  • New York, NY
National Provider Identifier
1023061330
Registry record updated Mar 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV006525-1 Issued in NY
Practice address
1246 Amsterdam Ave
New York, NY 10027-5924
Phone
(212) 316-2020
Fax
(212) 316-2020
NPI assigned
May 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV006525-1 NY Primary

Addresses

Primary practice location

1246 Amsterdam Ave
New York, NY 10027-5924

Mailing address

1246 Amsterdam Ave
New York, NY 10027-5924
Phone (212) 316-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060519000131 NY Practitioner - Optometry 1153332598 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV006525-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Q Optometrist PC Optometrist CurrentSince Sep 11, 2019 Accepting new patients
Epic Medical Group,Inc Past Accepting new patients
Grand Central Optical Co Inc Optometrist PastSince Dec 18, 2017 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7032/brand/1/csg/1/fhir/r4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1023061330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1246 AMSTERDAM AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100275924",
            "telephone_number": "212-316-2020",
            "fax_number": "212-316-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1246 AMSTERDAM AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100275924",
            "telephone_number": "212-316-2020",
            "fax_number": "212-316-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAUCH",
        "first_name": "JESSICA",
        "name_prefix": "Ms.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006525-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.