Organization Active NPI

Mahopac Ophthalmology PC

  • Ophthalmology Physician
  • Mahopac, NY
National Provider Identifier
1184631152
Registry record updated Oct 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
MAHOPAC OPHTHALMOLOGY PC
Practice address
7 Miller Rd
Mahopac, NY 10541-2219
Phone
(845) 628-8788
Fax
(845) 628-9581
NPI assigned
Aug 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2011

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

Authorized official

Name
Dr. Paula Lynne Coleman, MDNPI 1588683148
Title
President/Physician
Phone
(845) 628-8788

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
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

7 Miller Rd
Mahopac, NY 10541-2219

Mailing address

7 Miller Rd
Mahopac, NY 10541-2219
Phone (845) 628-8788

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060810000044 NY Part B Supplier - Clinic/Group Practice 6608768395 Receives reassigned benefits from 2 practitioners
Practice locations: Mahopac, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317686400000",
    "number": "1184631152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 MILLER RD",
            "city": "MAHOPAC",
            "state": "NY",
            "postal_code": "105412219",
            "telephone_number": "845-628-8788",
            "fax_number": "845-628-9581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 MILLER RD",
            "city": "MAHOPAC",
            "state": "NY",
            "postal_code": "105412219",
            "telephone_number": "845-628-8788",
            "fax_number": "845-628-9581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAHOPAC OPHTHALMOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2011-10-04",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "PRESIDENT/PHYSICIAN",
        "authorized_official_telephone_number": "845-628-8788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mahopac, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; 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.