Organization Active NPI

Uptown Optometry PLLC

  • Optometrist
  • East Greenbush, NY
National Provider Identifier
1043755671
Registry record updated Mar 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV005420-1 Issued in NY
Legal business name
UPTOWN OPTOMETRY PLLC
Practice address
2 Middlesex Rd
East Greenbush, NY 12061-2504
Phone
(518) 486-8989
Fax
(518) 486-8988
NPI assigned
Jan 6, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2017

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

Authorized official

Name
Dr. Edward Berger, O.D.NPI 1558497941
Title
Optometrist
Phone
(518) 486-8989

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 TUV005420-1 NY Primary

Addresses

Primary practice location

2 Middlesex Rd
East Greenbush, NY 12061-2504

Mailing address

2 Middlesex Rd
East Greenbush, NY 12061-2504
Phone (518) 486-8989

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170206000394 NY Part B Supplier - Clinic/Group Practice 6002199684 Receives reassigned benefits from 1 practitioner
Practice locations: East Greenbush, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1483660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488412800000",
    "number": "1043755671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MIDDLESEX RD",
            "city": "EAST GREENBUSH",
            "state": "NY",
            "postal_code": "120612504",
            "telephone_number": "518-486-8989",
            "fax_number": "518-486-8988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MIDDLESEX RD",
            "city": "EAST GREENBUSH",
            "state": "NY",
            "postal_code": "120612504",
            "telephone_number": "518-486-8989",
            "fax_number": "518-486-8988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPTOWN OPTOMETRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-06",
        "last_updated": "2017-03-02",
        "status": "A",
        "authorized_official_last_name": "BERGER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "518-486-8989",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV005420-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Greenbush, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2017; 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.