Active NPI
Richard O'Connor, OD
- Optometrist
- Elma, NY
National Provider Identifier
1104869643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 03521
- Practice address
- 980 West Maple Court
Elma, NY 14059-9530 - Phone
- (716) 652-0870
- Fax
- (716) 652-2071
- NPI assigned
- Jun 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 03521 | NY | Primary |
Addresses
Primary practice location
980 West Maple Court
Elma, NY 14059-9530
Mailing address
980 West Maple Court
Elma, NY 14059-9530
Phone (716) 652-0870
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 18, 2023 through Jan 18, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03521 | NY | MD | Optometrist |
| 3521 | NY | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Optometric Group, P.C. | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Optometrist
- Arcade, NY
- NPI 1235330929
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328745600000",
"number": "1104869643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "980 WEST MAPLE COURT",
"city": "ELMA",
"state": "NY",
"postal_code": "140599530",
"telephone_number": "716-652-0870",
"fax_number": "716-652-2071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "980 WEST MAPLE COURT",
"city": "ELMA",
"state": "NY",
"postal_code": "140599530",
"telephone_number": "716-652-0870",
"fax_number": "716-652-2071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'CONNOR",
"first_name": "RICHARD",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-13",
"last_updated": "2012-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "03521",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elma, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.