Individual provider Active NPI

Leo A Gaw, O.D

  • Optometrist
  • North Syracuse, NY
National Provider Identifier
1154550929
Registry record updated Jul 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
007414 Issued in NY
Practice address
125 Lawrence Rd E
North Syracuse, NY 13212-3844
Phone
(315) 455-5500
NPI assigned
Jul 14, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 007414 NY Primary

Addresses

Primary practice location

125 Lawrence Rd E
North Syracuse, NY 13212-3844

Mailing address

108 N Lorraine Ave # 2
Syracuse, NY 13210-3222
Phone (626) 202-8431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140930001750 NY Practitioner - Optometry 9234283441 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Astoria Vision Center Inc Optometrist CurrentSince Aug 25, 2014 Accepting new patients
Jackson Heights Optical Inc Optometrist CurrentSince Aug 25, 2014 Accepting new patients
Empire Vision Center, Inc Past Accepting new patients
Empire Vision Center Inc Optometrist PastSince Feb 28, 2010 Accepting new patients

Locations

3620 Broadway
Astoria, NY 11106
Phone (718) 204-2007

8325 37th Ave
Jackson Hts, NY 11372
Phone (718) 246-2725

Organizations & group practices 4

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": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247529600000",
    "number": "1154550929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 N LORRAINE AVE # 2",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132103222",
            "telephone_number": "626-202-8431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 LAWRENCE RD E",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132123844",
            "telephone_number": "315-455-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAW",
        "first_name": "LEO",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-14",
        "last_updated": "2009-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "007414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Syracuse, NY

Sources for this page

Verify at the official NPI Registry.