Active NPI
Andrea Tracy Sutton, OD
- Optometrist
- Staten Island, NY
National Provider Identifier
1386819340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- T004800
- Practice address
- 4338 Amboy Rd
Staten Island, NY 10312-3820 - Phone
- (718) 494-1319
- NPI assigned
- Apr 29, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | T004800 | NY | Primary |
Addresses
Primary practice location
4338 Amboy Rd
Staten Island, NY 10312-3820
Mailing address
4338 Amboy Rd
Staten Island, NY 10312-3820
Phone (718) 494-1319
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T004800 | NY | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Richmond Optometry PC | Optometrist | 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 and National Provider Directory roles.
-
- Optometrist
- Staten Island, NY
- NPI 1447174958
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349740800000",
"number": "1386819340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4338 AMBOY RD",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103123820",
"telephone_number": "718-494-1319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4338 AMBOY RD",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103123820",
"telephone_number": "718-494-1319"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUTTON",
"first_name": "ANDREA",
"middle_name": "TRACY",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-29",
"last_updated": "2012-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "T004800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.