Individual provider Active NPI

David Alan Burstein, OD

  • Optometrist
  • Buffalo, NY
National Provider Identifier
1215935994
Registry record updated Aug 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV004496 Issued in NY
Practice address
924 Kenmore Ave
Buffalo, NY 14216-1451
Phone
(716) 876-2020
Fax
(716) 876-3261
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV004496 NY Primary

Addresses

Primary practice location

924 Kenmore Ave
Buffalo, NY 14216-1451

Mailing address

924 Kenmore Ave
Buffalo, NY 14216-1451
Phone (716) 876-2020

Other identifiers 1

IdentifierTypeStateIssuer
00945620MedicaidNY

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
I20031222000325 NY Practitioner - Optometry 9638077290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kenmore Eye Care IncGroup PAC ID 5890754774, 2 clinicians

Practice addresses (Care Compare)

924 Kenmore Ave
Buffalo, NY 14216-1451
Phone (716) 876-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV004496NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kenmore Eyecare Inc. Optometrist CurrentSince Apr 18, 1997 Accepting new patients
Kenmore Eye Care Inc. Optometrist Current Accepting new patients
Healthstep Past Accepting new patients

Locations

606 N French Rd
Ste 7
Amherst, NY 14228
Phone (716) 688-8127

924 Kenmore Ave
Buffalo, NY 14216
Phone (716) 876-2020

224 Plaza Dr
Ste B
Williamsville, NY 14221
Phone (716) 688-8127

Organizations & group practices 3

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281312000000",
    "number": "1215935994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 KENMORE AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142161451",
            "telephone_number": "716-876-2020",
            "fax_number": "716-876-3261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 KENMORE AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142161451",
            "telephone_number": "716-876-2020",
            "fax_number": "716-876-3261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURSTEIN",
        "first_name": "DAVID",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2010-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV004496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00945620",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.