Individual provider Active NPI

Alexandria McKeen

  • Optometrist
  • Depew, NY
National Provider Identifier
1205635778
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
011279 Issued in NY
Practice address
4703 Transit Rd
Depew, NY 14043-4861
Phone
(716) 656-2011
NPI assigned
Mar 10, 2025
Last updated
Aug 12, 2025By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3061 MD
Optometrist 152W00000X 011279 NY Primary

Addresses

Primary practice location

4703 Transit Rd
Depew, NY 14043-4861

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442

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
I20250903001774 NY Practitioner - Optometry 8527569219 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
200 West Optics LLCGroup PAC ID 5395144380, 38 clinicians

Practice addresses (Care Compare)

4703 Transit Rd
Depew, NY 14043-4861
Phone (716) 656-2011

750 Dick Rd
Suite 1
Cheektowaga, NY 14225-3882
Phone (716) 684-1622

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3061MDMDOptometrist
011279NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
200 West Optics, LLC Optometrist CurrentSince Aug 25, 2025 Accepting new patients
200 West Optics, LLC Optometrist CurrentSince Aug 25, 2025 Accepting new patients
200 West Optics, LLC Optometrist Current Accepting new patients
200 West Optics, LLC Optometrist PastSince Jan 26, 2025 Accepting new patients

Locations

750 Dick Rd
Ste 1
Cheektowaga, NY 14225
Phone (716) 684-1622

4703 Transit Rd
Depew, NY 14043
Phone (716) 656-2011

1765 Central Park Ave
Yonkers, NY 10710
Phone (914) 961-1004

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

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": "1741564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1205635778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4703 TRANSIT RD",
            "city": "DEPEW",
            "state": "NY",
            "postal_code": "140434861",
            "telephone_number": "716-656-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEEN",
        "first_name": "ALEXANDRIA",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-03-10",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "3061",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "011279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Depew, NY

Sources for this page

Verify at the official NPI Registry.