Individual provider Active NPI

Bryan D. O'Neil, OD

  • Optometrist
  • Syracuse, NY
National Provider Identifier
1073007670
Registry record updated Jul 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
008793 Issued in NY
Practice address
4109 W Genesee St Ste 100
Syracuse, NY 13219
Phone
(315) 488-2020
NPI assigned
Jun 18, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 008793 NY Primary

Addresses

Primary practice location

4109 W Genesee St Ste 100
Syracuse, NY 13219

Mailing address

4109 W Genesee St Ste 100
Syracuse, NY 13219-1957
Phone (315) 488-2020

Other practice location 1

475 Irving Ave Ste 420
Syracuse, NY 13210-1573
Phone (315) 425-7722

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
I20180810000083 NY Practitioner - Optometry 7214285063 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lawrence Cecchi MD PCGroup PAC ID 1951552165, 3 clinicians

Practice addresses (Care Compare)

475 Irving Ave
Suite 420
Syracuse, NY 13210-1573
Phone (315) 425-7722

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lawrence Cecchi MD PC CurrentSince Jul 1, 2018 Accepting new patients
Auburn Eye Care Center Optometrist CurrentSince Apr 15, 2021 Accepting new patients
Empire Vision Center, Inc Past Accepting new patients

Locations

232 Genesee St
Auburn, NY 13021
Phone (315) 252-5622

6157 US Route 20
La Fayette, NY 13084
Phone (315) 677-3193

475 Irving Ave
Ste 420
Syracuse, NY 13210
Phone (315) 425-7722

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531785600000",
    "number": "1073007670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4109 W GENESEE ST STE 100",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132191957",
            "telephone_number": "315-488-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4109 W GENESEE ST STE 100",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13219",
            "telephone_number": "315-488-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "475 Irving Ave Ste 420",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132101573",
            "country_code": "US",
            "telephone_number": "315-425-7722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'NEIL",
        "first_name": "BRYAN",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-18",
        "last_updated": "2018-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "008793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.