Individual provider Active NPI

Pollyanna L Roach, OD

  • Optometrist
  • East Aurora, NY
National Provider Identifier
1033372305
Registry record updated Oct 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV007310 Issued in NY
Practice address
65 Hamlin Ave
East Aurora, NY 14052-1604
Phone
(716) 341-2270
NPI assigned
Jul 8, 2008
Last updated
Oct 26, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV007310 NY Primary

Addresses

Primary practice location

65 Hamlin Ave
East Aurora, NY 14052-1604

Mailing address

65 Hamlin Ave
East Aurora, NY 14052-1604
Phone (716) 341-2270

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
I20080721000402 NY Practitioner - Optometry 4587737820 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sightrite IncGroup PAC ID 0749404382, 6 clinicians

Practice addresses (Care Compare)

611 E 103Rd St
Brooklyn, NY 11236-2501
Phone (718) 240-3100

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV007310NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sightrite Inc Optometrist CurrentSince Aug 1, 2015 Accepting new patients
Eye Care Vision Optometry P.C. Optometrist CurrentSince Feb 1, 2022 Accepting new patients
John M. Brzezicki, Jr., O.D. Optometrist PastSince Jul 9, 2015 Accepting new patients

Locations

267 Broadway
Fl 2
Brooklyn, NY 11211
Phone (716) 912-5877

611 E 103rd St
Brooklyn, NY 11236
Phone (347) 374-4032

7144 Yellowstone Blvd
Forest Hills, NY 11375
Phone (718) 544-4300

10 Munson St
Le Roy, NY 14482
Phone (585) 591-6000

918 James St
Syracuse, NY 13203
Phone (315) 474-1561

134 Great East Neck Rd
West Babylon, NY 11704
Phone (631) 321-3850

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, 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": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445817600000",
    "number": "1033372305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 HAMLIN AVE",
            "city": "EAST AURORA",
            "state": "NY",
            "postal_code": "140521604",
            "telephone_number": "716-341-2270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 HAMLIN AVE",
            "city": "EAST AURORA",
            "state": "NY",
            "postal_code": "140521604",
            "telephone_number": "716-341-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "POLLYANNA",
        "middle_name": "L",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-08",
        "last_updated": "2015-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Aurora, NY

Sources for this page

Verify at the official NPI Registry.