Individual provider Active NPI

Nichole Elizabeth Pollard, OD

  • Optometrist
  • Rome, NY
National Provider Identifier
1205452810
Registry record updated Jun 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
009147 Issued in NY
Practice address
1320 Floyd Ave
Suite 1
Rome, NY 13440
Phone
(315) 337-3277
NPI assigned
Jun 19, 2020
Last updated
Jun 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 009147 NY Primary

Addresses

Primary practice location

1320 Floyd Ave
Suite 1
Rome, NY 13440

Mailing address

42 Merritt PL
New Hartford, NY 13413-2032
Phone (315) 525-9668

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200826000595 NY Practitioner - Optometry 2264859032 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Care Center of Rome IncGroup PAC ID 0648451724, 4 clinicians
Adirondack Eyecare Center IncGroup PAC ID 1850335944, 3 clinicians

Practice addresses (Care Compare)

1320 Floyd Ave
Rome, NY 13440-4615
Phone (315) 337-3277

151 Main St
Suite 1
Boonville, NY 13309-1309
Phone (315) 942-2122

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009147NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Adirondack Eyecare Center Inc Optometrist CurrentSince Jul 1, 2020 Accepting new patients
Poulin Eyecare Inc. Optometrist CurrentSince Jul 1, 2020 Accepting new patients
Poulin Optometric Eyecare , PLLC Optometrist CurrentSince Jul 1, 2020 Accepting new patients
Eye Care Center of Rome Inc Optometrist CurrentSince Jul 1, 2020 Accepting new patients

Locations

151 Main St
Boonville, NY 13309
Phone (315) 942-2122

151 Main St
#1
Boonville, NY 13309
Phone (315) 942-2122

94 Main St
Camden, NY 13316
Phone (315) 245-2443

1320 Floyd Ave
Rome, NY 13440
Phone (315) 337-3277

1320 Floyd Ave
Ste 1
Rome, NY 13440
Phone (315) 337-3277

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1592524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592524800000",
    "number": "1205452810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 MERRITT PL",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134132032",
            "telephone_number": "315-525-9668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 FLOYD AVE",
            "address_2": "SUITE 1",
            "city": "ROME",
            "state": "NY",
            "postal_code": "13440",
            "telephone_number": "315-337-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLARD",
        "first_name": "NICHOLE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-19",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "009147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, NY

Sources for this page

Verify at the official NPI Registry.