Individual provider Active NPI

Lucy Oconnor, OD

  • Optometrist
  • Fredonia, NY
National Provider Identifier
1083438071
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ORT011101 Issued in NY
Practice address
10401 Bennett Rd
Fredonia, NY 14063-1402
Phone
(716) 392-4001
NPI assigned
Nov 14, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ORT011101 NY Primary

Addresses

Primary practice location

10401 Bennett Rd
Fredonia, NY 14063-1402

Mailing address

23 Forestal Dr
Hamburg, NY 14075-4612
Phone (716) 392-4001

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
I20241209004027 NY Practitioner - Optometry 3072049493 Reassigns benefits to 1 organization
Practice locations: Fredonia, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ORT011101NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Empire Vision Center Inc Optometrist CurrentSince Nov 25, 2024 Accepting new patients
Empire Vision Center, Inc CurrentSince Nov 25, 2024 Accepting new patients

Locations

2680 Delaware Ave
Ste C
Buffalo, NY 14216
Phone (716) 873-1241

560 Troy Schenectady Rd
#7
Latham, NY 12110
Phone (518) 783-0090

1930 South Rd
#105
Poughkeepsie, NY 12601
Phone (845) 298-3200

2590 W Ridge Rd
Rochester, NY 14626
Phone (585) 227-7150

2921 Erie Blvd E
Syracuse, NY 13224
Phone (315) 446-3145

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": "1731542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1083438071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 FORESTAL DR",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140754612",
            "telephone_number": "716-392-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10401 BENNETT RD",
            "city": "FREDONIA",
            "state": "NY",
            "postal_code": "140631402",
            "telephone_number": "716-392-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCONNOR",
        "first_name": "LUCY",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-14",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "ORT011101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredonia, NY

Sources for this page

Verify at the official NPI Registry.