Eryn Mae Doe

Primary specialty

OptometristTaxonomy code 152W00000X

License

0079491 Issued in NY

Practice address

3 Lyon Place Suite 101
Ogdensburg, NY 13669-2590

Phone

(315) 393-3937

Fax

(315) 393-0591

NPI assigned

Nov 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• North Country Ophthalmology Associates PC

  • Ophthalmology Physician
  • Ogdesnburg, NY
  • NPI 1326107251
  NPD (past)
• North Country Ophthalmology Associates PC

  • Eyewear Supplier
  • Ogdensburg, NY
  • NPI 1407227044
  NPD (past)

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443398400000",
    "number": "1154494045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 LYON PLACE SUITE 101",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136692590",
            "telephone_number": "315-393-3937",
            "fax_number": "315-393-0591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 LYON PLACE SUITE 101",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136692590",
            "telephone_number": "315-393-3937",
            "fax_number": "315-393-0591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOE",
        "first_name": "ERYN",
        "middle_name": "MAE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2015-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "0079491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02580876",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rezel Villanueva Diokno
• Kimberly Marie Distasio
• Salvadore Ditta, RPA
• Ashley Dixon, RN BSN
• Riane Dodge, PA
• Amber Donnelly, RN
• Mark C Donnelly, PHARMD, RPH
• Amy Doser, PTA
• Mary Michelle Downing, LPN
• Jamie Lynn Downs, LPN

• Optometrist in Ogdensburg, NY
• Providers in Ogdensburg, 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 28, 2015; 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.