Individual provider Active NPI

Ryan Whinery

  • Optometrist
  • Vestal, NY
National Provider Identifier
1417465568
Registry record updated Jun 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV008747 Issued in NY
Practice address
3455 Vestal Pkwy E
Vestal, NY 13850-2147
Phone
(330) 720-0115
NPI assigned
Jan 10, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV008747 NY Primary

Addresses

Primary practice location

3455 Vestal Pkwy E
Vestal, NY 13850-2147

Mailing address

3455 Vestal Pkwy
Vestal, NY 13850-2147
Phone (607) 722-2020

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
I20180620003175 NY Practitioner - Optometry 1153676838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York Optometry Professional PLLCGroup PAC ID 5890169841, 26 clinicians

Practice addresses (Care Compare)

3455 Vestal Pkwy E
Vestal, NY 13850-2147
Phone (607) 722-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV008747NYMDOptometrist
008747NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New York Optometry Professional PLLC Optometrist CurrentSince Dec 10, 2022 Accepting new patients

Locations

75 Main St
Sidney, NY 13838
Phone (607) 563-2442

3455 Vestal Pkwy E
Vestal, NY 13850
Phone (607) 722-2020

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": "1515542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528416000000",
    "number": "1417465568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3455 VESTAL PKWY",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138502147",
            "telephone_number": "607-722-2020",
            "fax_number": "607-722-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 VESTAL PKWY E",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138502147",
            "telephone_number": "330-720-0115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHINERY",
        "first_name": "RYAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-10",
        "last_updated": "2018-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV008747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestal, NY

Sources for this page

Verify at the official NPI Registry.