Individual provider Active NPI

Mackenzie Ruth Biggers

  • Optometrist
  • Queensbury, NY
National Provider Identifier
1366178261
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
009753-01 Issued in NY
Practice address
357 Bay Rd Ste 6
Queensbury, NY 12804-3051
Phone
(518) 792-3304
NPI assigned
Jul 25, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 4

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.

Medicare Care Compare profile

Specialty
Optometry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glens Falls Optometry PC (2 clinicians)

Practice addresses (Care Compare)

357 Bay Rd
Suite 6
Queensbury, NY 12804-3051
Phone (518) 792-3304

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230606001592 NY Practitioner - Optometry 2769849801 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
009753NYMDMental Health Counselor
009753-01NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Glens Falls Optometry PC Optometrist Current
since Jun 25, 2023
Accepting new patients
Windsor Hospital Corporation Past
since Jul 1, 2022
Accepting new patients
O'Leary Chiropractic, PLLC Past
since Jun 25, 2023
Accepting new patients

Locations

357 Bay Rd
Ste 6
Queensbury, NY 12804
Phone (518) 792-3304

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 030.0133963 VT
Optometrist 152W00000X 009753-01 NY Primary

Addresses

NPPES NPI Registry

Primary practice location

357 Bay Rd Ste 6
Queensbury, NY 12804-3051

Mailing address

357 Bay Rd Ste 6
Queensbury, NY 12804-3051
Phone (518) 792-3304

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 7, 2023.

{
    "created_epoch": "1658707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1366178261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "357 BAY RD STE 6",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128043051",
            "telephone_number": "518-792-3304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "357 BAY RD STE 6",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128043051",
            "telephone_number": "518-792-3304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIGGERS",
        "first_name": "MACKENZIE",
        "middle_name": "RUTH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-25",
        "last_updated": "2023-09-07",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VT",
            "license": "030.0133963",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "009753-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queensbury, NY

Sources for this page

Verify at the official NPI Registry.