Individual provider Active NPI

Brian Eugene Bleiler, OD

  • Optometrist
  • Watkins Glen, NY
National Provider Identifier
1255327854
Registry record updated Jan 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
VUT005098 Issued in NY
Practice address
406 E 4TH St
Watkins Glen, NY 14891-1217
Phone
(607) 535-4842
Fax
(607) 398-3413
NPI assigned
Sep 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X VUT005098 NY Primary

Addresses

Primary practice location

406 E 4TH St
Watkins Glen, NY 14891-1217

Mailing address

207 Madison Ave
Elmira, NY 14901-3204
Phone (607) 734-2984

Other identifiers 1

IdentifierTypeStateIssuer
410020897OtherRR MEDICARE

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
I20110628000174 NY Practitioner - Optometry 8527066133 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guthrie Medical Group PCGroup PAC ID 6002728656, 795 clinicians

Practice addresses (Care Compare)

207 Madison Ave
Elmira, NY 14901-3204
Phone (607) 734-2984

719 Lake St
Elmira, NY 14901-2538
Phone (607) 734-1554

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
VUT005098NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Guthrie Medical Group, P.C. CurrentSince Dec 1, 2022 Accepting new patients
Southern Tier Assn F/T Visually Impaired Inc CurrentSince Jan 1, 1992 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Dec 1, 2022 Accepting new patients
Guthrie Medical Group PC Past Accepting new patients

Locations

130 Center Way
Corning, NY 14830
Phone (607) 936-9971

1 Park Ln
Corning, NY 14830
Phone (607) 734-1554

719 Lake St
Elmira, NY 14901
Phone (607) 734-1554

207 Madison Ave
Elmira, NY 14901
Phone (607) 734-2984

406 E 4th St
Watkins Glen, NY 14891
Phone (607) 535-4842

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

Interoperability endpoints

  • Direct secure messaging: bbleiler182376@direct-guthrie.org

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327449600000",
    "number": "1255327854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 MADISON AVE",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013204",
            "telephone_number": "607-734-2984",
            "fax_number": "607-398-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 E 4TH ST",
            "city": "WATKINS GLEN",
            "state": "NY",
            "postal_code": "148911217",
            "telephone_number": "607-535-4842",
            "fax_number": "607-398-3413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEILER",
        "first_name": "BRIAN",
        "middle_name": "EUGENE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2012-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "VUT005098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "410020897",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watkins Glen, NY

Sources for this page

Verify at the official NPI Registry.