Active NPI
Bruce C. Minger
- Optician
- Newark, NY
National Provider Identifier
1336164318
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 004325
- Practice address
- 117 E Union St
Newark, NY 14513-1503 - Phone
- (315) 331-7917
- Fax
- (315) 331-7917
- NPI assigned
- Jul 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 004325 | NY | Primary |
Addresses
Primary practice location
117 E Union St
Newark, NY 14513-1503
Mailing address
236 State Route 88 S
Newark, NY 14513-9140
Phone (315) 331-2647
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01782094 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optical Dispensary Inc | Optician | Current | Accepting new patients |
Locations
117 E Union St
Newark, NY 14513
Phone (315) 331-5070
Organizations & group practices 1
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": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1336164318",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "236 STATE ROUTE 88 S",
"city": "NEWARK",
"state": "NY",
"postal_code": "145139140",
"telephone_number": "315-331-2647",
"fax_number": "315-331-7917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 E UNION ST",
"city": "NEWARK",
"state": "NY",
"postal_code": "145131503",
"telephone_number": "315-331-7917",
"fax_number": "315-331-7917"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINGER",
"first_name": "BRUCE",
"middle_name": "C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-12",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NY",
"license": "004325",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01782094",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newark, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.