NPIMap

Organization Active NPI

M B Kayani Physician PC

Doing business as dba Watertown Eye Center

  • Ophthalmology Physician
  • Watertown, NY
National Provider Identifier
1417907346
Registry record updated Nov 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
199713 Issued in NY
Legal business name
M B KAYANI PHYSICIAN PC
Doing business as
dba Watertown Eye Center
Practice address
1815 State St
Watertown, NY 13601-9407
Phone
(315) 788-6070
Fax
(315) 788-1950
NPI assigned
May 11, 2006
Last updated
Nov 21, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2013

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

Authorized official

Name
Mrs. Joedy E. Muller
Title
Billing Manager
Phone
(315) 681-4320

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X 199713 NY Primary

Addresses

Primary practice location

1815 State St
Watertown, NY 13601-9407

Mailing address

1815 State St
Watertown, NY 13601-9407
Phone (315) 788-6070

Other names 1

  • dba Watertown Eye Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051011000798 NY Part B Supplier - Clinic/Group Practice 7012932833 Receives reassigned benefits from 10 practitioners
2 other NPIs on this enrollment
Practice locations: Lowville, NY; Potsdam, NY; Ogdensburg, NY; Massena, NY; Gouverneur, NY

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384992000000",
    "number": "1417907346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 STATE ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136019407",
            "telephone_number": "315-788-6070",
            "fax_number": "315-788-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 STATE ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136019407",
            "telephone_number": "315-788-6070",
            "fax_number": "315-788-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M B KAYANI PHYSICIAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2013-11-21",
        "status": "A",
        "authorized_official_last_name": "MULLER",
        "authorized_official_first_name": "JOEDY",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "315-681-4320",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "199713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba Watertown Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.