Active NPI
Frederick Rolland Edmunds Jr., O.D.
- Sports Vision Optometrist
- Victor, NY
National Provider Identifier
1104991660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Vision Optometrist
- License
- T004397-1
- Practice address
- 274 W Main St
Victor, NY 14564-1157 - Phone
- (585) 880-4818
- NPI assigned
- Nov 21, 2006
- Last updated
- Jul 6, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4397 | NY | |
| Optometrist | 152W00000X | T004397-1 | NY | |
| Corneal and Contact Management Optometrist | 152WC0802X | T004397-1 | NY | |
| Sports Vision Optometrist | 152WS0006X | T004397-1 | NY | Primary |
| Vision Therapy Optometrist | 152WV0400X | T004397-1 | NY |
Addresses
Primary practice location
274 W Main St
Victor, NY 14564-1157
Mailing address
7745 Peepers Holw
Victor, NY 14564-8914
Phone (585) 924-3688
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | fedmunds9682@direct.urmc.rochester.edu | Direct | |
| Direct Messaging Address | fedmunds9682@direct.urmc.rochester.edu | Direct |
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: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4397 | NY | MD | Optometrist |
| T004397-1 | NY | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Strong Eye Care | Current | Accepting new patients |
Locations
601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555
601 Elmwood Ave
#659
Rochester, NY 14642
Phone (585) 275-0378
601 Elmwood Ave
#888
Rochester, NY 14642
Phone (585) 784-9582
Interoperability endpoints
- fedmunds9682@direct.urmc.rochester.edu
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Ophthalmology Physician
- Rochester, NY
- NPI 1760413447
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688601600000",
"number": "1104991660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7745 PEEPERS HOLW",
"city": "VICTOR",
"state": "NY",
"postal_code": "145648914",
"telephone_number": "585-924-3688"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "274 W MAIN ST",
"city": "VICTOR",
"state": "NY",
"postal_code": "145641157",
"telephone_number": "585-880-4818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDMUNDS",
"first_name": "FREDERICK",
"middle_name": "ROLLAND",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-21",
"last_updated": "2023-07-06",
"certification_date": "2020-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "4397",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "T004397-1",
"primary": false
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "NY",
"license": "T004397-1",
"primary": false
},
{
"code": "152WS0006X",
"taxonomy_group": "",
"desc": "Optometrist, Sports Vision",
"state": "NY",
"license": "T004397-1",
"primary": true
},
{
"code": "152WV0400X",
"taxonomy_group": "",
"desc": "Optometrist, Vision Therapy",
"state": "NY",
"license": "T004397-1",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "fedmunds9682@direct.urmc.rochester.edu",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "OTHER",
"address_1": "601 Elmwood Ave",
"city": "Rochester",
"state": "NY",
"country_code": "US",
"postal_code": "146420001",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "fedmunds9682@direct.urmc.rochester.edu",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "OTHER",
"address_1": "601 Elmwood Ave",
"city": "Rochester",
"state": "NY",
"country_code": "US",
"postal_code": "146420001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Victor, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.