Individual provider Active NPI

Chad Anthony Vaughn, O.D.

  • Optometrist
  • Saratoga Springs, NY
National Provider Identifier
1275569279
Registry record updated Apr 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV006630-1 Issued in NY
Practice address
170 S Broadway
Saratoga Springs, NY 12866-4555
Phone
(518) 306-5290
Fax
(518) 306-5291
NPI assigned
Jun 23, 2006
Last updated
Apr 12, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 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 TUV006630-1 NY Primary

Addresses

Primary practice location

170 S Broadway
Saratoga Springs, NY 12866-4555

Mailing address

170 S Broadway
Saratoga Springs, NY 12866-4555
Phone (518) 581-8595

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
I20040603000169 NY Practitioner - Optometry 9436131570 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vaughn Vision LLCGroup PAC ID 3779751938, 2 clinicians

Practice addresses (Care Compare)

58 Church St
Saratoga Springs, NY 12866-2070
Phone (518) 306-5290

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV006630-1NYMDOptometrist
006630NYMDPodiatrist
4305MAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Vaughn Vision LLC CurrentSince Feb 1, 2011 Accepting new patients
Bay Optical, Inc Past Accepting new patients
Albany Troy Cataract and Laser Associates Past Accepting new patients
Laurie a Runnerstrom, OD Optometrist Past Accepting new patients
Silhouette Eye Studio LLC Optometrist PastSince Sep 4, 2008 Accepting new patients

Locations

170 S Broadway
Saratoga Springs, NY 12866
Phone (518) 274-3123

58 Church St
Saratoga Springs, NY 12866
Phone (518) 240-0090

Organizations & group practices 5

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334188800000",
    "number": "1275569279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 S BROADWAY",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128664555",
            "telephone_number": "518-581-8595",
            "fax_number": "518-306-5291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 S BROADWAY",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128664555",
            "telephone_number": "518-306-5290",
            "fax_number": "518-306-5291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "CHAD",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2012-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006630-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga Springs, NY

Sources for this page

Verify at the official NPI Registry.