David Andrew Paul

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV007347-1 Issued in NY

Practice address

11050 Mount Belvedere Blvd
USA Meddac/Credentials
Fort Drum, NY 13602-5438

Phone

(315) 772-4025

Fax

(315) 772-9498

NPI assigned

Oct 14, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Luxottica of America Inc

  dba Lenscrafters #E895

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)

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

{
    "created_epoch": "1223942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223942400000",
    "number": "1063664720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4145 COYE RD",
            "city": "JAMESVILLE",
            "state": "NY",
            "postal_code": "130786505",
            "telephone_number": "315-657-4044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11050 MOUNT BELVEDERE BLVD",
            "address_2": "USA MEDDAC/CREDENTIALS",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136025438",
            "telephone_number": "315-772-4025",
            "fax_number": "315-772-9498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL",
        "first_name": "DAVID",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-14",
        "last_updated": "2008-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007347-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US ARMY",
            "identifier": "VADOOO",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Padron, DDS
• Bethany Brooke Pajak, D.O.
• Soham Parikh, MD
• Eleanor Park
• Gregory John Pataky, APA-C
• Dean C Pedersen, M.D.
• Gregory H Pelcak, P.A.
• Samantha Renee Pelcak, PH.D.
• Tanya Monique Perez, PA
• Brandon Anthony Perroots, DDS

• Optometrist in Fort Drum, NY
• Providers in Fort Drum, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.