Individual provider Active NPI

Owen David Henry, OD

  • Optometrist
  • Orchard Park, NY
National Provider Identifier
1093473746
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
009493 Issued in NY
Practice address
3151 Southwestern Blvd
Orchard Park, NY 14127-1212
Phone
(716) 674-6030
NPI assigned
Nov 30, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 009493 NY Primary

Addresses

Primary practice location

3151 Southwestern Blvd
Orchard Park, NY 14127-1212

Mailing address

3151 Southwestern Blvd
Orchard Park, NY 14127-1212
Phone (716) 674-6030

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
I20220222001054 NY Practitioner - Optometry 8325432180 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southtowns Ophthalmology PCGroup PAC ID 0143593483, 4 clinicians

Practice addresses (Care Compare)

3151 Southwestern Blvd
Orchard Park, NY 14127-1212
Phone (716) 674-6030

Merit-based Incentive Payment System (MIPS)

Final score
92.24 of 100Reported as group
Quality
94.45
Improvement activities
40
Cost
81.53

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southtowns Ophthalmology PC CurrentSince Dec 1, 2021 Accepting new patients

Locations

3151 Southwestern Blvd
Orchard Park, NY 14127
Phone (716) 674-6030

Interoperability endpoints

  • Direct secure messaging: ohenry@sec.medentdirect.com

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": "1638230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1093473746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3151 SOUTHWESTERN BLVD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271212",
            "telephone_number": "716-674-6030",
            "fax_number": "716-674-6052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3151 SOUTHWESTERN BLVD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271212",
            "telephone_number": "716-674-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "OWEN",
        "middle_name": "DAVID",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-30",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "009493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.