Elizabeth Ann Dannebrock, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV007844-1 Issued in NY

Practice address

500 Davison Rd
Lockport, NY 14094-4021

Phone

(716) 434-8063

Fax

(716) 434-2845

NPI assigned

Jun 25, 2012

Last updated

Sep 9, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Elizabeth Ann Hetrick Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: elizabeth.hetrick@direct.revolutionehr.com

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.

• Davison Road Optical Inc

  dba Newfane Family Eyecare

  • Eyewear Supplier
  • Newfane, NY
  • NPI 1669599247
  NPD (past)

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1134483191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 DAVISON RD",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140944021",
            "telephone_number": "716-434-8063",
            "fax_number": "716-434-2845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 DAVISON RD",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140944021",
            "telephone_number": "716-434-8063",
            "fax_number": "716-434-2845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANNEBROCK",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-25",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007844-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "HETRICK",
            "middle_name": "ANN",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Crystal Springs Medical PC
• Mary Jo Currie
• Chelsea Ann Dagostino
• Dale Association
• Patricia J Danaher, M.D.
• Lisa Anne Dannebrock
• David P. Nichols, M.D., P.C.
• Davison Road Optical Inc (Newfane Family Eyecare)
• Davison Road Optical, Inc.
• Juan De Rosas, MD

• Optometrist in Lockport, NY
• Providers in Lockport, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; 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.