Individual provider Active NPI

John Tranchese, OPTICIAN

  • Optician
  • Commack, NY
National Provider Identifier
1053449868
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
C4340 Issued in NY
Practice address
11 Roxbury Dr
Commack, NY 11725-1324
Phone
(631) 543-8732
Fax
(631) 543-8010
NPI assigned
Mar 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X C4340 NY Primary

Addresses

Primary practice location

11 Roxbury Dr
Commack, NY 11725-1324

Mailing address

11 Roxbury Dr
Commack, NY 11725-1324
Phone (631) 543-8732

Other identifiers 1

IdentifierTypeStateIssuer
01459847MedicaidNY

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C4340NYMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1053449868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 ROXBURY DR",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117251324",
            "telephone_number": "631-543-8732",
            "fax_number": "631-543-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 ROXBURY DR",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117251324",
            "telephone_number": "631-543-8732",
            "fax_number": "631-543-8010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRANCHESE",
        "first_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "OPTICIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "C4340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01459847",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.