Individual provider Active NPI

Naomi R Knoller, O.D.

  • Optometrist
  • Hawthorne, NY
National Provider Identifier
1285691253
Registry record updated Feb 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T005003-1 Issued in NY
Practice address
40 Saw Mill River Rd
Westchester Ophthalmology - Suite FB2
Hawthorne, NY 10532-1535
Phone
(914) 579-2344
Fax
(914) 579-2346
NPI assigned
Apr 26, 2006
Last updated
Feb 18, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2016

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T005003-1 NY Primary
Optometrist 152W00000X 04984 NJ
Corneal and Contact Management Optometrist 152WC0802X T005003-1 NY
Low Vision Rehabilitation Optometrist 152WL0500X T005003-1 NY
Low Vision Rehabilitation Optometrist 152WL0500X 04984 NJ

Addresses

Primary practice location

40 Saw Mill River Rd
Westchester Ophthalmology - Suite FB2
Hawthorne, NY 10532-1535

Mailing address

680 Camperdown Rd
Teaneck, NJ 07666-2056
Phone (201) 287-1144

Other identifiers 1

IdentifierTypeStateIssuer
01644182MedicaidNY

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
I20110512000166 NY Practitioner - Optometry 4688672306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

40 Saw Mill River Rd
Suite FB2
Hawthorne, NY 10532-1528
Phone 91457923443

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
04984NJMDOptometrist
T005003-1NYMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Naomi R. Knoller, O.D., P.C. Optometrist CurrentSince Feb 27, 2011 Accepting new patients
North Jersey Center for Sight, LLC Low Vision Rehabilitation Past Accepting new patients
Alden Leifer, MD. PC PastSince Jan 26, 2010 Accepting new patients

Locations

40 Saw Mill River Rd
Ste FB2
Hawthorne, NY 10532
Phone (914) 579-2344

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455753600000",
    "number": "1285691253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 CAMPERDOWN RD",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076662056",
            "telephone_number": "201-287-1144",
            "fax_number": "201-287-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 SAW MILL RIVER RD",
            "address_2": "WESTCHESTER OPHTHALMOLOGY - SUITE FB2",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105321535",
            "telephone_number": "914-579-2344",
            "fax_number": "914-579-2346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOLLER",
        "first_name": "NAOMI",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2016-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "T005003-1",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "04984",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NY",
            "license": "T005003-1",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "NY",
            "license": "T005003-1",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "NJ",
            "license": "04984",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01644182",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, NY

Sources for this page

Verify at the official NPI Registry.