Individual provider Active NPI

Andrew Deron Dohanich, OD

  • Optometrist
  • New York, NY
National Provider Identifier
1073304754
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
011185 Issued in NY
Practice address
33 W 42ND St
New York, NY 10036-8005
Phone
(212) 938-4000
NPI assigned
May 13, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 011185 NY Primary

Addresses

Primary practice location

33 W 42ND St
New York, NY 10036-8005

Mailing address

7 Grove St
Marathon, NY 13803-2205
Phone (607) 344-1621

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
I20251010002671 NY Practitioner - Optometry 3072010305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2025
Medicare assignment
May accept Medicare assignment
Group practices
State of New York Comptrollers OfficeGroup PAC ID 0840101770, 171 clinicians

Practice addresses (Care Compare)

33 W 42ND St
New York, NY 10036-8005
Phone (212) 938-4001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011185NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
State of New York Comptrollers Office Optometrist CurrentSince Jul 31, 2025 Accepting new patients
State of New York Comptrollers Office CurrentSince Jul 31, 2025 Accepting new patients

Locations

33 W 42nd St
Fl 10
New York, NY 10036
Phone (212) 780-4930

University Eye Ctr
New York, NY 10087

33 W 42nd St
New York, NY 10036
Phone (212) 780-4930

Organizations & group practices 2

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": "1747094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1073304754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 GROVE ST",
            "city": "MARATHON",
            "state": "NY",
            "postal_code": "138032205",
            "telephone_number": "607-344-1621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 W 42ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100368005",
            "telephone_number": "212-938-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOHANICH",
        "first_name": "ANDREW",
        "middle_name": "DERON",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-13",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "011185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.