Han Song Blackmer

Primary specialty

OpticianTaxonomy code 156FX1800X

License

55-006556 Issued in NY

Practice address

4609 W Genesee St
Syracuse, NY 13219-1733

Phone

(315) 345-8004

Fax

(315) 295-2617

NPI assigned

Oct 30, 2015

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Blackmer Family Eyewear

  • Eyewear Supplier
  • Syracuse, NY
  • NPI 1376908095
  NPD (past) Authorized official

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

{
    "created_epoch": "1446163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1376916205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4609 W GENESEE ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132191733",
            "telephone_number": "315-345-8004",
            "fax_number": "315-295-2617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4609 W GENESEE ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132191733",
            "telephone_number": "315-345-8004",
            "fax_number": "315-295-2617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMER",
        "first_name": "HAN",
        "middle_name": "SONG",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-30",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "55-006556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUSINESS",
            "identifier": "1376908095",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Black, R.N.
• Reana T Black
• Robert M Black, MD
• Tavia Black, PRS
• Blackmer Family Eyewear
• Pamela M. Blackmer, R.D.
• Myron Blackmon
• Briana Blackshear
• Stuart L Blackwood, M.D.
• Blair Counseling Services

• Optician in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Optician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; 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.