Active NPI
McHael Sebastian Gzik, LICENSED OPTICIAN
- Optician
- Syracuse, NY
National Provider Identifier
1376682112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- C003601-1
- Practice address
- 116 E Washington St
Syracuse, NY 13202-1618 - Phone
- (315) 478-3937
- Fax
- (315) 472-2692
- NPI assigned
- Feb 6, 2007
- 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 | C003601-1 | NY | Primary |
Addresses
Primary practice location
116 E Washington St
Syracuse, NY 13202-1618
Mailing address
4213 Streamwood Dr
Liverpool, NY 13090-1330
Phone (315) 622-9304
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C003601-1 | NY | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Logan Optical, Inc | Optician | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376682112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4213 STREAMWOOD DR",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "130901330",
"telephone_number": "315-622-9304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 E WASHINGTON ST",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132021618",
"telephone_number": "315-478-3937",
"fax_number": "315-472-2692"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GZIK",
"first_name": "MCHAEL",
"middle_name": "SEBASTIAN",
"name_prefix": "Mr.",
"credential": "LICENSED OPTICIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NY",
"license": "C003601-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.