Individual provider Active NPI

John McKinney, O.D.

  • Optometrist
  • Kingston, NY
National Provider Identifier
1306996632
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T95381 Issued in NY
Practice address
1300 Ulster Ave
Kingston, NY 12401-1501
Phone
(914) 336-5878
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T95381 NY Primary

Addresses

Primary practice location

1300 Ulster Ave
Kingston, NY 12401-1501

Mailing address

27 Bakertown Rd
Accord, NY 12404-5901
Phone (845) 626-2379

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
I20040831001595 NY Practitioner - Optometry 2567437619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fine and Park LLCGroup PAC ID 5799836383, 3 clinicians

Practice addresses (Care Compare)

576 Broadway
Suite 578
Kingston, NY 12401-3902
Phone (845) 331-1212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T95381NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Fine & Park LLC Optometrist CurrentSince Dec 5, 2019 Accepting new patients
Stephen J Fine,OD Optometrist Past Accepting new patients

Locations

576 Broadway
#578
Kingston, NY 12401
Phone (845) 331-1212

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306996632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 BAKERTOWN RD",
            "city": "ACCORD",
            "state": "NY",
            "postal_code": "124045901",
            "telephone_number": "845-626-2379",
            "fax_number": "845-336-5890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 ULSTER AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124011501",
            "telephone_number": "914-336-5878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "JOHN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "T95381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.