Individual provider Active NPI

Bonnie Sager, O.D.

  • Optometrist
  • Oyster Bay, NY
National Provider Identifier
1194704908
Registry record updated Sep 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
003688 Issued in NY
Practice address
13 E Main St
Oyster Bay, NY 11771-2405
Phone
(516) 922-2533
NPI assigned
Jan 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 003688 NY Primary

Addresses

Primary practice location

13 E Main St
Oyster Bay, NY 11771-2405

Mailing address

60 Salem Ridge Dr
Huntington, NY 11743-3015
Phone (631) 423-3215

Other identifiers 1

IdentifierTypeStateIssuer
00494826MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090409000155 NY Practitioner - Optometry 4082761010 Practice locations: Oyster Bay, NY

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
003688NYMDSports Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Luxottica of America Inc Past Accepting new patients
Luxottica of America Inc Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251936000000",
    "number": "1194704908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 SALEM RIDGE DR",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117433015",
            "telephone_number": "631-423-3215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 E MAIN ST",
            "city": "OYSTER BAY",
            "state": "NY",
            "postal_code": "117712405",
            "telephone_number": "516-922-2533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAGER",
        "first_name": "BONNIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2009-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "003688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00494826",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oyster Bay, NY

Sources for this page

Verify at the official NPI Registry.