Individual provider Active NPI

Carolyn Rose Lederman, MD

  • Pediatric Ophthalmology and Strabismus Specialist Physician
  • Purchase, NY
National Provider Identifier
1184660904
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Ophthalmology and Strabismus Specialist PhysicianTaxonomy code 207WX0110X
License
193530 Issued in NY
Practice address
3020 Westchester Avenue
Suite 402
Purchase, NY 10577-2561
Phone
(914) 417-6441
Fax
(914) 948-2020
NPI assigned
Jun 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 193530 NY
Ophthalmology Physician 207W00000X 039687 CT
Pediatric Ophthalmology and Strabismus Specialist Physician 207WX0110X 193530 NY Primary

Addresses

Primary practice location

3020 Westchester Avenue
Suite 402
Purchase, NY 10577-2561

Mailing address

3020 Westchester Avenue
Suite 402
Purchase, NY 10577-2561
Phone (914) 417-6441

Other identifiers 1

IdentifierTypeStateIssuer
01748329MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050926000350 NY Practitioner - Ophthalmology 4486688702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1992
Medicare assignment
May accept Medicare assignment
Group practices
Lederman and Lederman LLPGroup PAC ID 1456241769, 2 clinicians

Practice addresses (Care Compare)

3020 Westchester Ave
Purchase, NY 10577-2561

3020 Westchester Ave
Suite 201
Purchase, NY 10577-2597
Phone (914) 417-6441

Hospital & facility affiliations

  • White Plains Hospital Center Hospital, White Plains, NY, CCN 330304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
039687CTMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lederman and Lederman LLP Ophthalmology CurrentSince May 1, 2008 Accepting new patients
Negrin MD PLLC PastSince Jun 1, 2017 Accepting new patients

Locations

3020 Westchester Ave
Ste 201
Purchase, NY 10577
Phone (914) 417-6441

3020 Westchester Ave
Purchase, NY 10577
Phone (914) 253-6464

3020 Westchester Ave
Ste 402
Purchase, NY 10577
Phone (914) 417-6441

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1184660904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 WESTCHESTER AVENUE",
            "address_2": "SUITE 402",
            "city": "PURCHASE",
            "state": "NY",
            "postal_code": "105772561",
            "telephone_number": "914-417-6441",
            "fax_number": "914-948-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 WESTCHESTER AVENUE",
            "address_2": "SUITE 402",
            "city": "PURCHASE",
            "state": "NY",
            "postal_code": "105772561",
            "telephone_number": "914-417-6441",
            "fax_number": "914-948-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDERMAN",
        "first_name": "CAROLYN",
        "middle_name": "ROSE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "193530",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CT",
            "license": "039687",
            "primary": false
        },
        {
            "code": "207WX0110X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist",
            "state": "NY",
            "license": "193530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01748329",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Purchase, NY

Sources for this page

Verify at the official NPI Registry.