Organization Active NPI

Childrenseye Care Physicians of Cny, LLC

  • Ophthalmology Physician
  • Syracuse, NY
National Provider Identifier
1265590103
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
CHILDRENSEYE CARE PHYSICIANS OF CNY, LLC
Practice address
1810 Erie Blvd E
Syracuse, NY 13210-1230
Phone
(315) 422-4321
NPI assigned
Dec 4, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Walter Woodhull Merriam, M.D.
Title
Owner
Phone
(315) 422-4321

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1810 Erie Blvd E
Syracuse, NY 13210-1230

Mailing address

1810 Erie Blvd E
Syracuse, NY 13210-1230
Phone (315) 422-4321

Other identifiers 1

IdentifierTypeStateIssuer
00550032MedicaidNY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265590103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 ERIE BLVD E",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101230",
            "telephone_number": "315-422-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 ERIE BLVD E",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101230",
            "telephone_number": "315-422-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDRENSEYE CARE PHYSICIANS OF CNY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MERRIAM",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "WOODHULL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-422-4321",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00550032",
            "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 Aug 22, 2020; 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.