Individual provider Active NPI

Kenneth Jay Scherick, OD

  • Optometrist
  • New York, NY
National Provider Identifier
1124162672
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV003290-1 Issued in NY
Practice address
608 2ND Ave
New York, NY 10016-4859
Phone
(212) 686-1653
Fax
(212) 686-1654
NPI assigned
Feb 17, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV003290-1 NY Primary

Addresses

Primary practice location

608 2ND Ave
New York, NY 10016-4859

Mailing address

608 2ND Ave
New York, NY 10016-4859
Phone (212) 686-1653

Other practice location 1

344 3rd Ave
New York, NY 10010-2331
Phone (212) 679-9690

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV003290-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Rye Eye Care OD PLLC Optometrist PastSince Jul 25, 2023 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.

NPI Registry JSON

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

{
    "created_epoch": "1171670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1124162672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 2ND AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100164859",
            "telephone_number": "212-686-1653",
            "fax_number": "212-686-1654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 2ND AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100164859",
            "telephone_number": "212-686-1653",
            "fax_number": "212-686-1654"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "344 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100102331",
            "country_code": "US",
            "telephone_number": "212-679-9690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHERICK",
        "first_name": "KENNETH",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-17",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV003290-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.