John S Ettenson, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

174308-1 Issued in NY

Practice address

1 Theall Rd
Rye, NY 10580-1404

Phone

(914) 848-8800

Fax

(914) 682-6403

NPI assigned

Mar 16, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: jettenson@hiemail.healtheconnections.org

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381881600000",
    "number": "1396714820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 WESTCHESTER AVE",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106042901",
            "telephone_number": "914-681-3146",
            "fax_number": "914-682-6403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 THEALL RD",
            "city": "RYE",
            "state": "NY",
            "postal_code": "105801404",
            "telephone_number": "914-848-8800",
            "fax_number": "914-682-6403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETTENSON",
        "first_name": "JOHN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2013-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "174308-1",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CT",
            "license": "041999",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01072893",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BCBS",
            "identifier": "21E601",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "133757245",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Elias, MD
• Katherine Elmore, LMHC
• Emily McNamara, Psychologist PLLC
• Danielle E Engler, M.D.
• Eric, a, Lubin MD,PC
• Yvonne Fagan
• Daniel Eric Fass, M.D.
• Ioana Alina Faur, LAC
• Kristina Martimucci Feldman, DO
• Stephanie Feldman, LMSW

• Ophthalmology Physician in Rye, NY
• Providers in Rye, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; 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.