Individual provider Active NPI

Michelle Cecilia Sturckler, OD

  • Optometrist
  • Vestal, NY
National Provider Identifier
1043996994
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
009779 Issued in NY
Practice address
3455 Vestal Pkwy E
Vestal, NY 13850-2147
Phone
(607) 722-2020
Fax
(607) 722-3937
NPI assigned
Jun 26, 2023
Last updated
Jul 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 009779 NY Primary

Addresses

Primary practice location

3455 Vestal Pkwy E
Vestal, NY 13850-2147

Mailing address

37 Beechknoll Rd
Binghamton, NY 13903-3608
Phone (607) 743-1965

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
I20230725001876 NY Practitioner - Optometry 3779944681 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York Optometry Professional PLLCGroup PAC ID 5890169841, 26 clinicians

Practice addresses (Care Compare)

3455 Vestal Pkwy E
Vestal, NY 13850-2147
Phone (607) 722-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009779NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
New York Optometry Professional PLLC Optometrist CurrentSince May 31, 2024 Accepting new patients
Empire Vision Center, Inc CurrentSince Jul 10, 2023 Accepting new patients
Empire Vision Center Inc Optometrist CurrentSince Jul 10, 2023 Accepting new patients

Locations

1290 Upper Front St
Binghamton, NY 13901
Phone (607) 722-3417

2680 Delaware Ave
Ste C
Buffalo, NY 14216
Phone (716) 873-1241

560 Troy Schenectady Rd
#7
Latham, NY 12110
Phone (518) 783-0090

1930 South Rd
#105
Poughkeepsie, NY 12601
Phone (845) 298-3200

2590 W Ridge Rd
Rochester, NY 14626
Phone (585) 227-7150

75 Main St
Sidney, NY 13838
Phone (607) 563-2442

2921 Erie Blvd E
Syracuse, NY 13224
Phone (315) 446-3145

3455 Vestal Pkwy E
Vestal, NY 13850
Phone (607) 722-2020

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": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1043996994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 BEECHKNOLL RD",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139033608",
            "telephone_number": "607-743-1965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 VESTAL PKWY E",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138502147",
            "telephone_number": "607-722-2020",
            "fax_number": "607-722-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STURCKLER",
        "first_name": "MICHELLE",
        "middle_name": "CECILIA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-26",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "009779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestal, NY

Sources for this page

Verify at the official NPI Registry.