Organization Active NPI

David J. Braun, O.D., P.C.

  • Health Maintenance Organization
  • Syracuse, NY
National Provider Identifier
1306178207
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
006089 Issued in NY
Legal business name
DAVID J. BRAUN, O.D., P.C.
Practice address
120 Julian PL
Original Eyewear
Syracuse, NY 13210-3460
Phone
(315) 214-5858
Fax
(315) 218-5966
NPI assigned
Feb 3, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Authorized official

Name
Dr. David J. Braun, ODNPI 1700806973
Title
Optometrist
Phone
(315) 214-5858

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X 006089 NY Primary

Addresses

Primary practice location

120 Julian PL
Original Eyewear
Syracuse, NY 13210-3460

Mailing address

120 Julian PL
Original Eyewear
Syracuse, NY 13210-3460
Phone (315) 214-5858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100713000201 NY Part B Supplier - Clinic/Group Practice 9032241963 Receives reassigned benefits from 3 practitioners
Practice locations: Watertown, NY; East Syracuse, NY

National Provider Directory

National Provider Directory

Locations

120 Julian Pl
Ste 3
Syracuse, NY 13210

120 Julian Pl
Syracuse, NY 13210
Phone (315) 214-5858

53-59 Public Sq
Ste 101
Watertown, NY 13601
Phone (315) 782-7872

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1265155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704672000000",
    "number": "1306178207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 JULIAN PL",
            "address_2": "ORIGINAL EYEWEAR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132103460",
            "telephone_number": "315-214-5858",
            "fax_number": "315-218-5966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 JULIAN PL",
            "address_2": "ORIGINAL EYEWEAR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132103460",
            "telephone_number": "315-214-5858",
            "fax_number": "315-218-5966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID J. BRAUN, O.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-03",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A",
        "authorized_official_last_name": "BRAUN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "315-214-5858",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NY",
            "license": "006089",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.