NPIMap

Organization Active NPI

Clifton Park Eye Care Optometric Associates PLLC

  • Eyewear Supplier
  • Clifton Park, NY
National Provider Identifier
1104039304
Registry record updated Apr 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
TUV005180 Issued in NY
Legal business name
CLIFTON PARK EYE CARE OPTOMETRIC ASSOCIATES PLLC
Practice address
1618 Route 9
Clifton Park, NY 12065-4304
Phone
(518) 371-3353
NPI assigned
May 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2015

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

Authorized official

Name
Ms. Patti A Root
Title
Office Manager
Phone
(518) 371-3353

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X TUV005180 NY Primary

Addresses

Primary practice location

1618 Route 9
Clifton Park, NY 12065-4304

Mailing address

1618 Route 9
Clifton Park, NY 12065-4304
Phone (518) 371-3353

Other names 1

  • Clifton Park Eye Care Associates Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110303000744 NY Part B Supplier - Clinic/Group Practice 1456533025 Receives reassigned benefits from 3 practitioners
Practice locations: Halfmoon, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430265600000",
    "number": "1104039304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1618 ROUTE 9",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120654304",
            "telephone_number": "518-371-3353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1618 ROUTE 9",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120654304",
            "telephone_number": "518-371-3353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIFTON PARK EYE CARE OPTOMETRIC ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2015-04-29",
        "status": "A",
        "authorized_official_last_name": "ROOT",
        "authorized_official_first_name": "PATTI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "518-371-3353",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NY",
            "license": "TUV005180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clifton Park Eye Care Associates",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Clifton Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2015; 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.