Organization Active NPI

Traveling Optometry PC

  • Optometrist
  • Syracuse, NY
National Provider Identifier
1245475573
Registry record updated Dec 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV006002 Issued in NY
Legal business name
TRAVELING OPTOMETRY PC
Practice address
224 Harrison St
Suite 218
Syracuse, NY 13202-3056
Phone
(315) 295-0467
Fax
(315) 295-1096
NPI assigned
Dec 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2009

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

Authorized official

Name
Dr. Tricia D. Rose, OD
Title
President
Phone
(315) 295-0467

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X TUV006002 NY Primary

Addresses

Primary practice location

224 Harrison St
Suite 218
Syracuse, NY 13202-3056

Mailing address

224 Harrison St
Suite 218
Syracuse, NY 13202-3056
Phone (315) 295-0467

Other identifiers 1

IdentifierTypeStateIssuer
03119853MedicaidNY

National Provider Directory

National Provider Directory

Locations

224 Harrison St
Ste 218
Syracuse, NY 13202
Phone (315) 295-0467

NPI Registry JSON

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

{
    "created_epoch": "1229385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260921600000",
    "number": "1245475573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 HARRISON ST",
            "address_2": "SUITE 218",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023056",
            "telephone_number": "315-295-0467",
            "fax_number": "315-295-1096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 HARRISON ST",
            "address_2": "SUITE 218",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023056",
            "telephone_number": "315-295-0467",
            "fax_number": "315-295-1096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAVELING OPTOMETRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-16",
        "last_updated": "2009-12-16",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "TRICIA",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "315-295-0467",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03119853",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.