Active NPI
Giuseppina M Russo, OD
- Optometrist
- Medford, NY
National Provider Identifier
1033170733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TUV0063921
- Practice address
- 2799 RT 112
Davis Vision at King Kuhlen Shopping Center
Medford, NY 11763 - Phone
- (631) 289-3937
- Fax
- (631) 207-0913
- NPI assigned
- Mar 31, 2006
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | TUV0063921 | NY | Primary |
Addresses
Primary practice location
2799 RT 112
Davis Vision at King Kuhlen Shopping Center
Medford, NY 11763
Mailing address
2921 Erie Blvd E
Syracuse, NY 13224
Phone (315) 445-7465
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TUV0063921 | NY | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Empire Vision Center Inc | Optometrist | Past | Accepting new patients |
| Empire Vision Center, Inc | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Optometrist
- Syracuse, NY
- NPI 1750358826
-
- Eyewear Supplier
- Attleboro, MA
- NPI 1730635582
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561680000000",
"number": "1033170733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2921 ERIE BLVD E",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "13224",
"telephone_number": "315-445-7465",
"fax_number": "315-445-7675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2799 RT 112",
"address_2": "DAVIS VISION AT KING KUHLEN SHOPPING CENTER",
"city": "MEDFORD",
"state": "NY",
"postal_code": "11763",
"telephone_number": "631-289-3937",
"fax_number": "631-207-0913"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSO",
"first_name": "GIUSEPPINA",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-31",
"last_updated": "2019-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "TUV0063921",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Medford, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.