Individual provider Active NPI

Scott J Bushinger, O.D.

  • Optometrist
  • Syracuse, NY
National Provider Identifier
1417142837
Registry record updated Apr 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV007211-1 Issued in NY
Practice address
5792 Widewaters Pkwy Ste 101
Syracuse, NY 13214-1847
Phone
(315) 422-4412
NPI assigned
Sep 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV007211-1 NY Primary

Addresses

Primary practice location

5792 Widewaters Pkwy Ste 101
Syracuse, NY 13214-1847

Mailing address

5792 Widewaters Pkwy Ste 101
Syracuse, NY 13214-1847
Phone (315) 422-4412

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
I20071023000163 NY Practitioner - Optometry 7012003015 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Costello Eye Physicians and Surgeons PLLCGroup PAC ID 8628074937, 11 clinicians

Practice addresses (Care Compare)

250 E State St
Herkimer, NY 13350-2335
Phone (315) 894-3132

2730 State Route 12B
Hamilton, NY 13346-2113
Phone (315) 797-8330

4 Ellinwood Dr
New Hartford, NY 13413-1110
Phone (315) 797-8330

409 Chestnut St
Oneonta, NY 13820-2120
Phone (607) 644-0556

53 Public SQ
Suite 102
Watertown, NY 13601-2674
Phone (315) 691-6379

Merit-based Incentive Payment System (MIPS)

Final score
83.32 of 100Reported as group
Quality
97.06
Improvement activities
40
Cost
48.3

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV007211-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Empire Vision Center, Inc CurrentSince Dec 12, 2020 Accepting new patients
Costello Eye Physicians & Surgeons, PLLC Optometrist CurrentSince Oct 30, 2024 Accepting new patients
Empire Vision Center Inc Optometrist CurrentSince Dec 12, 2020 Accepting new patients
Eye Designs Unlimited Optometry PC Optometrist PastSince Nov 12, 2012 Accepting new patients
Eye Consultants of Syracuse PC PastSince Jun 4, 2023 Accepting new patients

Locations

2680 Delaware Ave
Ste C
Buffalo, NY 14216
Phone (716) 873-1241

2730 State Route 12B
Hamilton, NY 13346
Phone (315) 797-8330

250 E State St
Herkimer, NY 13350
Phone (315) 866-3668

8511 126th St
Kew Gardens, NY 11415
Phone (718) 849-7773

8521 126th St
Kew Gardens, NY 11415
Phone (718) 849-7773

560 Troy Schenectady Rd
#7
Latham, NY 12110
Phone (518) 783-0090

4551 Commercial Dr
New Hartford, NY 13413
Phone (315) 768-1000

4 Ellinwood Dr
New Hartford, NY 13413
Phone (315) 624-5960

131 Main St
Ste 201
Oneida, NY 13421
Phone (315) 363-1110

409 Chestnut St
Oneonta, NY 13820
Phone (607) 644-0556

1930 South Rd
#105
Poughkeepsie, NY 12601
Phone (845) 298-3200

2590 W Ridge Rd
Rochester, NY 14626
Phone (585) 227-7150

2921 Erie Blvd E
Syracuse, NY 13224
Phone (315) 446-3145

Interoperability endpoints

  • Direct secure messaging: sjb@ceps2056.srs-direct.com
  • FHIR API: https://app.meldrx.com/api/fhir/Freedom_CEP

Organizations & group practices 5

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": "1189382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556323200000",
    "number": "1417142837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5792 WIDEWATERS PKWY STE 101",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132141847",
            "telephone_number": "315-422-4412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5792 WIDEWATERS PKWY STE 101",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132141847",
            "telephone_number": "315-422-4412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSHINGER",
        "first_name": "SCOTT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-10",
        "last_updated": "2019-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007211-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.