Individual provider Active NPI

Alyssa A Putman, O.D.

  • Optometrist
  • Ithaca, NY
National Provider Identifier
1407108624
Registry record updated Apr 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8087T Issued in TX
Practice address
40 Catherwood Rd
Ithaca, NY 14850-1056
Phone
(607) 257-2333
Fax
(607) 257-1763
NPI assigned
Oct 11, 2012
Last updated
Apr 11, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8087T TX Primary
Optometrist 152W00000X TUV008069 NY

Addresses

Primary practice location

40 Catherwood Rd
Ithaca, NY 14850-1056

Mailing address

103 Test Rd
Apt 3
Newfield, NY 14867
Phone (607) 368-0529

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140401000233 NY Practitioner - Optometry 8527204007 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sightrite IncGroup PAC ID 0749404382, 6 clinicians

Practice addresses (Care Compare)

2150 Saint Paul St
Rochester, NY 14621-1415
Phone (515) 342-5540

382 W Church St
Elmira, NY 14901-2621
Phone (607) 733-2694

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score
94.41 of 100Reported as group
Quality
85.08
Promoting interoperability
95
Improvement activities
40
Cost
78.96

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
TUV008069NYMDOptometrist
8087TTXMDOptometrist
008069NYMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Ophthalmology Services Inc. CurrentSince Jan 4, 2021 Accepting new patients
Sightrite Inc Optometrist CurrentSince Feb 12, 2017 Accepting new patients
Alyssa a Putman Optometrist PC Optometrist CurrentSince Apr 12, 2024 Accepting new patients

Locations

267 Broadway
Fl 2
Brooklyn, NY 11211
Phone (716) 912-5877

1176 Main St
Buffalo, NY 14209
Phone (716) 881-7900

382 W Church St
Elmira, NY 14901
Phone (607) 733-2694

301 Sterling Dr
Orchard Park, NY 14127
Phone (716) 677-6500

2150 Saint Paul St
Rochester, NY 14621
Phone (585) 342-5540

Organizations & group practices 3

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": "1349913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397174400000",
    "number": "1407108624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 TEST RD",
            "address_2": "APT 3",
            "city": "NEWFIELD",
            "state": "NY",
            "postal_code": "14867",
            "telephone_number": "607-368-0529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 CATHERWOOD RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501056",
            "telephone_number": "607-257-2333",
            "fax_number": "607-257-1763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTMAN",
        "first_name": "ALYSSA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-11",
        "last_updated": "2014-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8087T",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV008069",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.