Jacob B List, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV0070721 Issued in NY

Practice address

140 State Route 104
Oswego Plaza Empire Vision Centers
Oswego, NY 13126

Phone

(315) 342-0727

Fax

(315) 342-3044

NPI assigned

Sep 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Empire Vision Center Inc

  • Optometrist
  • Syracuse, NY
  • NPI 1750358826
  NPD (past)
• Empire Vision Center, Inc

  • Eyewear Supplier
  • Attleboro, MA
  • NPI 1730635582
  NPD (past)

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194307200000",
    "number": "1326140336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 ERIE BLVD EAST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13224",
            "telephone_number": "315-445-7465",
            "fax_number": "315-445-7675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 STATE ROUTE 104",
            "address_2": "OSWEGO PLAZA EMPIRE VISION CENTERS",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "13126",
            "telephone_number": "315-342-0727",
            "fax_number": "315-342-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIST",
        "first_name": "JACOB",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV0070721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allyson Lindsay
• Kelly Sue Lindsley, RN
• Taylor Lipiarz
• Rose Lisa Lipton, M.S.
• Melissa Lee Lisk, RN
• Kaitlyn T Litsch
• Danielle Lloyd, MS,OTR/L
• Eileen Donna Loban, M.S.
• Laurel Annette Lochner
• Kelly Lockwood Ferrente, O.T.

• Optometrist in Oswego, NY
• Providers in Oswego, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.