Individual provider Active NPI

Steven P Jannen

  • Optician
  • Syracuse, NY
National Provider Identifier
1073803565
Registry record updated Apr 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
005319-1 Issued in NY
Practice address
4952 Elgin Cir
Syracuse, NY 13215-2261
Phone
(315) 492-1774
NPI assigned
Apr 18, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 005319-1 NY Primary

Addresses

Primary practice location

4952 Elgin Cir
Syracuse, NY 13215-2261

Mailing address

133 Sunridge Ave
Camillus, NY 13031-1414
Phone (315) 492-1774

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
005319-1NYMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Jannens Optical Past Accepting new patients

Organizations & group practices 1

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": "1303084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303084800000",
    "number": "1073803565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 SUNRIDGE AVE",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130311414",
            "telephone_number": "315-492-1774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4952 ELGIN CIR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132152261",
            "telephone_number": "315-492-1774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANNEN",
        "first_name": "STEVEN",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-18",
        "last_updated": "2011-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "005319-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2011; 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.