NPIMap

Organization Active NPI

Western New York Medical Practice, P.C.

  • Optician
  • Rochester, NY
National Provider Identifier
1104598796
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
WESTERN NEW YORK MEDICAL PRACTICE, P.C.
Practice address
2301 Lac de Ville Blvd
Rochester, NY 14618-5646
Phone
(585) 244-0332
NPI assigned
Oct 1, 2021
Organization subpart
Yes
Parent organization
WESTERN NEW YORK MEDICAL PRACTICE, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Authorized official

Name
Nichole S Holder
Title
Director- Payer Enrollment
Phone
(585) 922-0293

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 156FX1800X Primary
Eyewear Supplier 332H00000X

Addresses

Primary practice location

2301 Lac de Ville Blvd
Rochester, NY 14618-5646

Mailing address

2301 Lac de Ville Blvd
Rochester, NY 14618-5646
Phone (585) 244-0332

Other names 1

  • WNY Eye Care - Brighton Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Western New York Medical Practice PC13 organizations share this tax ID, including this one
Part of
Western New York Medical Practice PC

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733961600000",
    "number": "1104598796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 LAC DE VILLE BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146185646",
            "telephone_number": "585-244-0332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 LAC DE VILLE BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146185646",
            "telephone_number": "585-244-0332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN NEW YORK MEDICAL PRACTICE, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WESTERN NEW YORK MEDICAL PRACTICE, P.C.",
        "enumeration_date": "2021-10-01",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A",
        "authorized_official_last_name": "HOLDER",
        "authorized_official_first_name": "NICHOLE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DIRECTOR- PAYER ENROLLMENT",
        "authorized_official_telephone_number": "585-922-0293"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WNY Eye Care - Brighton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.