Individual provider Active NPI

Kathleen Marie Gaynor, OD

  • Optometrist
  • Johnson City, NY
National Provider Identifier
1407803752
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV006927 Issued in NY
Practice address
48 Harrison Street
Johnson City, NY 13790
Phone
(607) 729-5016
Fax
(607) 729-7574
NPI assigned
May 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV006927 NY Primary

Addresses

Primary practice location

48 Harrison Street
Johnson City, NY 13790

Mailing address

48 Harrison Street
Johnson City, NY 13790
Phone (607) 729-5016

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
I20060310000614 NY Practitioner - Optometry 8921015215 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV006927NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sightrite Inc Optometrist CurrentSince Jun 27, 2016 Accepting new patients

Locations

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

236 Broadway
Ste 220
Brooklyn, NY 11211

301 Nantucket Dr
Endicott, NY 13760
Phone (607) 754-2700

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.

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1407803752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 HARRISON STREET",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "13790",
            "telephone_number": "607-729-5016",
            "fax_number": "607-729-7574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 HARRISON STREET",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "13790",
            "telephone_number": "607-729-5016",
            "fax_number": "607-729-7574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYNOR",
        "first_name": "KATHLEEN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-30",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, NY

Sources for this page

Verify at the official NPI Registry.