NPIMap

Organization Active NPI

John M. Brzezicki, Jr., O.D.

  • Optometrist
  • Orchard Park, NY
National Provider Identifier
1164728952
Registry record updated Jan 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TU002605-1 Issued in NY
Legal business name
JOHN M. BRZEZICKI, JR., O.D.
Practice address
6421 W Quaker St
Orchard Park, NY 14127-2354
Phone
(716) 662-4525
Fax
(716) 662-4138
NPI assigned
Jan 27, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2011

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

Authorized official

Name
Dr. John Myron Brzezicki Jr., O.D.
Title
Optometrist
Phone
(716) 662-4525

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X TU002605-1 NY Primary

Addresses

Primary practice location

6421 W Quaker St
Orchard Park, NY 14127-2354

Mailing address

6421 W Quaker St
Orchard Park, NY 14127-2354
Phone (716) 662-4525

Other identifiers 2

IdentifierTypeStateIssuer
441540262OtherNYRAILROAD MEDICARE
00654784MedicaidNY

National Provider Directory

National Provider Directory

Locations

6421 W Quaker St
Orchard Park, NY 14127
Phone (716) 662-4525

Practitioners & affiliated clinicians

Practitioners 7

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": "1296086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296086400000",
    "number": "1164728952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6421 W QUAKER ST",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141272354",
            "telephone_number": "716-662-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6421 W QUAKER ST",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141272354",
            "telephone_number": "716-662-4525",
            "fax_number": "716-662-4138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN M. BRZEZICKI, JR., O.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-27",
        "last_updated": "2011-01-27",
        "status": "A",
        "authorized_official_last_name": "BRZEZICKI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MYRON",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "716-662-4525",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TU002605-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "441540262",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00654784",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; 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.