Individual provider Active NPI

Danielle R. Smith, O.D.

  • Optometrist
  • Buffalo, NY
National Provider Identifier
1316940661
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
VUT006402 Issued in NY
Practice address
64 Hager St
Buffalo, NY 14208-1327
Phone
(212) 764-0008
NPI assigned
May 31, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X VUT006402 NY Primary

Addresses

Primary practice location

64 Hager St
Buffalo, NY 14208-1327

Mailing address

267 Broadway FL 2
Brooklyn, NY 11211-6216
Phone (212) 764-0008

Other practice location 1

2469 State Route 19 N
Warsaw, NY 14569-9336
Phone (585) 786-2288

Other identifiers 1

IdentifierTypeStateIssuer
02188732MedicaidNY

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
I20100222000184 NY Practitioner - Optometry 1254475791 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Care Vision Optometry PCGroup PAC ID 2365848165, 32 clinicians

Practice addresses (Care Compare)

918 James St
Syracuse, NY 13203-2503
Phone (646) 921-1738

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
VUT006402NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care Vision Optometry P.C. Optometrist CurrentSince Oct 20, 2022 Accepting new patients

Locations

228 E Route 59
Nanuet, NY 10954
Phone (718) 280-5436

918 James St
Syracuse, NY 13203
Phone (315) 474-1561

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": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1316940661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 BROADWAY FL 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112116216",
            "telephone_number": "212-764-0008",
            "fax_number": "585-786-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 HAGER ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142081327",
            "telephone_number": "212-764-0008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2469 State Route 19 N",
            "address_purpose": "LOCATION",
            "city": "Warsaw",
            "state": "NY",
            "postal_code": "145699336",
            "country_code": "US",
            "telephone_number": "585-786-2288",
            "fax_number": "585-786-3699",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DANIELLE",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-31",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "VUT006402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02188732",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.