Individual provider Active NPI

Jeffrey Slaney Williams Sr., O.D.

  • Optometrist
  • Riverhead, NY
National Provider Identifier
1225024490
Registry record updated Jan 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3809 Issued in NY
Practice address
887 Old Country Rd
Suite K-L
Riverhead, NY 11901-2115
Phone
(631) 727-2858
Fax
(631) 727-2866
NPI assigned
Sep 23, 2005
Last updated
Jan 8, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3809 NY Primary

Addresses

Primary practice location

887 Old Country Rd
Suite K-L
Riverhead, NY 11901-2115

Mailing address

887 Old Country Rd
Suite K-L
Riverhead, NY 11901-2115
Phone (631) 727-2858

Other identifiers 1

IdentifierTypeStateIssuer
C29481OtherMEDICARE ID

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
I20060309000442 NY Practitioner - Optometry 6901813310 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sound Vision Care, IncGroup PAC ID 5496801417, 6 clinicians
SVC of Riverhead LLCGroup PAC ID 8921437500, 5 clinicians
SVC of Southold LLCGroup PAC ID 7810326709, 3 clinicians

Practice addresses (Care Compare)

1224 Ostrander Ave
Riverhead, NY 11901-2109
Phone (631) 727-2858

44210 County Rd
48 Suite 1
Southold, NY 11971-5032
Phone (631) 765-3092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3809NYMDOptometrist
003809NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Fresh Eyes Inc Optometrist CurrentSince Nov 1, 2020 Accepting new patients
SVC of Murray Hill, LLC Optometrist CurrentSince Nov 1, 2020 Accepting new patients
SVC of Manhasset LLC Optometrist CurrentSince Feb 1, 2021 Accepting new patients
SVC of Coram LLC Optometrist CurrentSince Jan 5, 2020 Accepting new patients
SVC of Southold LLC Optometrist CurrentSince Jan 5, 2020 Accepting new patients
Long Island Optometric Eyecare,PC Optometrist CurrentSince Sep 1, 2020 Accepting new patients
SVC of Riverhead LLC Optometrist CurrentSince Jan 5, 2020 Accepting new patients
SVC of Fresh Meadows LLC Optometrist CurrentSince Nov 1, 2020 Accepting new patients
Abraham T. Winter,M.D.P.C PastSince Sep 1, 2020 Accepting new patients
Jeffrey S. Williams, Jr Past Accepting new patients
Continental Vision, Inc. PastSince Sep 9, 2020 Accepting new patients

Locations

6130A 190th St
Fresh Meadows, NY 11365
Phone (718) 454-8484

1360 Montauk Hwy
Ste 2E
Mastic, NY 11950
Phone (631) 281-2474

1721 N Ocean Ave
Ste A
Medford, NY 11763
Phone (631) 447-2020

458 3rd Ave
New York, NY 10016
Phone (212) 696-5590

433 Plandome Rd
Plandome, NY 11030
Phone (516) 627-0208

1224 Ostrander Ave
Riverhead, NY 11901
Phone (631) 727-2858

887 Old Country Rd
Ste Gkl
Riverhead, NY 11901
Phone (631) 727-2858

44210 County Road 48
Ste 1
Southold, NY 11971
Phone (631) 765-3092

Organizations & group practices 12

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": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357603200000",
    "number": "1225024490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "887 OLD COUNTRY RD",
            "address_2": "SUITE K-L",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012115",
            "telephone_number": "631-727-2858",
            "fax_number": "631-727-2866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "887 OLD COUNTRY RD",
            "address_2": "SUITE K-L",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012115",
            "telephone_number": "631-727-2858",
            "fax_number": "631-727-2866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JEFFREY",
        "middle_name": "SLANEY",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2013-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "3809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "C29481",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

Verify at the official NPI Registry.