Eyesight Ophthalmology P.C.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

205998 Issued in NY

Legal business name

EYESIGHT OPHTHALMOLOGY P.C.

Doing business as

EyeSight Medical Center

Practice address

4041 Delaware Ave
Suite 100
Tonawanda, NY 14150-6850

Phone

(716) 837-5200

Fax

(716) 837-8750

NPI assigned

Sep 14, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Nicholas A Stathopoulos, M.D.NPI 1487642682

Title

President

Phone

(716) 517-0680

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• EyeSight Medical Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicholas A Stathopoulos, MD

  • Ophthalmology Physician
  • Tonawanda, NY
  • NPI 1487642682
  Medicare reassignment NPD Authorized official
• John M Erhart, M.D

  • Ophthalmology Physician
  • New Port Richey, FL
  • NPI 1477644268
  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491350400000",
    "number": "1093810830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4041 DELAWARE AVE",
            "address_2": "SUITE 100",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141506850",
            "telephone_number": "716-837-5200",
            "fax_number": "716-837-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4041 DELAWARE AVE",
            "address_2": "SUITE 100",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141506850",
            "telephone_number": "716-837-5200",
            "fax_number": "716-837-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYESIGHT OPHTHALMOLOGY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2017-04-05",
        "status": "A",
        "authorized_official_last_name": "STATHOPOULOS",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "716-517-0680",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "205998",
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00603329",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EyeSight Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ophthalmology Physician in Tonawanda, NY
• Providers in Tonawanda, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.