Organization Active NPI

Hometown Primary Optometry PLLC

  • Optometrist
  • Cambridge, NY
National Provider Identifier
1164316824
Registry record updated Jun 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
HOMETOWN PRIMARY OPTOMETRY PLLC
Practice address
15 W Main St
Cambridge, NY 12816-1168
Phone
(518) 677-5422
Fax
(518) 677-5134
NPI assigned
Jun 6, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2025

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

Authorized official

Name
Dr. Gerald G Mattison, ODNPI 1740323047
Title
Owner
Phone
(518) 584-2620

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

15 W Main St
Cambridge, NY 12816-1168

Mailing address

15 W Main St
Cambridge, NY 12816-1168
Phone (518) 677-5422

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250814002491 NY Part B Supplier - Clinic/Group Practice 3375042757 Receives reassigned benefits from 1 practitioner
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Saratoga Springs, NY; Cambridge, NY; Gloversville, NY

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Hometown Primary Optometry PLLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1749168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749168000000",
    "number": "1164316824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 W MAIN ST",
            "city": "CAMBRIDGE",
            "state": "NY",
            "postal_code": "128161168",
            "telephone_number": "518-677-5422",
            "fax_number": "518-677-5134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 W MAIN ST",
            "city": "CAMBRIDGE",
            "state": "NY",
            "postal_code": "128161168",
            "telephone_number": "518-677-5422",
            "fax_number": "518-677-5134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMETOWN PRIMARY OPTOMETRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-06",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A",
        "authorized_official_last_name": "MATTISON",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "518-584-2620",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.