NPIMap

Organization Active NPI

Jeanette L. Bergstrom Dba Burnt Hills Optical

Doing business as Burnt Hills Optical

  • Optician
  • Burnt Hills, NY
National Provider Identifier
1184899783
Registry record updated Jul 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
JEANETTE L. BERGSTROM DBA BURNT HILLS OPTICAL
Doing business as
Burnt Hills Optical
Practice address
793 State Route 50
Burnt Hills, NY 12027-9501
Phone
(518) 399-6130
Fax
(518) 399-4604
NPI assigned
Apr 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2008

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

Authorized official

Name
Mrs. Jeanette L. Bergstrom
Title
Owner
Phone
(518) 399-6130

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X Primary

Addresses

Primary practice location

793 State Route 50
Burnt Hills, NY 12027-9501

Mailing address

PO Box 209
793 Route 50
Burnt Hills, NY 12027-0209
Phone (518) 399-6130

Other names 1

  • Burnt Hills Optical Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215388800000",
    "number": "1184899783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 209",
            "address_2": "793 ROUTE 50",
            "city": "BURNT HILLS",
            "state": "NY",
            "postal_code": "120270209",
            "telephone_number": "518-399-6130",
            "fax_number": "518-399-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "793 STATE ROUTE 50",
            "city": "BURNT HILLS",
            "state": "NY",
            "postal_code": "120279501",
            "telephone_number": "518-399-6130",
            "fax_number": "518-399-4604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEANETTE L. BERGSTROM DBA BURNT HILLS OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-24",
        "last_updated": "2008-07-07",
        "status": "A",
        "authorized_official_last_name": "BERGSTROM",
        "authorized_official_first_name": "JEANETTE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "518-399-6130",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Burnt Hills Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burnt Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2008; 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.