Richard H Pagan, OD
Individual provider Active NPI Optometrist · Pine Bush, NY
NPI 1235138561 · NPPES record last updated Aug 10, 2010
Key facts
- NPI
- 1235138561
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- TUV006249-1 (NY)
- Practice address
- 70 Main St.
Pine Bush, NY 12566 - Phone
- (845) 744-2003
- Fax
- (845) 744-6260
- NPI assigned
- Jul 19, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- New England College of Optometry, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Pine Bush Optometric PC
Practice addresses (Care Compare)
70 Main St
Pine Bush, NY 12566-6436
Phone (845) 744-2003
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040618000695 | NY | Practitioner - Optometry |
6800871542 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006249 | NY | MD | Mental Health Counselor |
| TUV006249-1 | NY | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pine Bush Optometric PC | Optometrist | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | TUV006249-1 | NY | Yes |
Addresses
Primary practice location
70 Main St.
Pine Bush, NY 12566
Mailing address
PO Box 949
Pine Bush, NY 12566-0949
Phone (845) 744-2003
Other providers in Pine Bush, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.