Individual provider Active NPI

Robert N Saidel, OD

  • Optometrist
  • Gouverneur, NY
National Provider Identifier
1437338266
Registry record updated Apr 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0003785 Issued in NY
Practice address
181 E Main St
Gouverneur, NY 13642-1552
Phone
(315) 287-1644
Fax
(315) 287-4419
NPI assigned
Oct 29, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0003785 NY Primary
Eyewear Supplier 332H00000X P017003785 NY

Addresses

Primary practice location

181 E Main St
Gouverneur, NY 13642-1552

Mailing address

181 E Main St
PO Box 326
Gouverneur, NY 13642-1552
Phone (315) 287-1644

Other identifiers 1

IdentifierTypeStateIssuer
00624002MedicaidNY

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
I20120327000009 NY Practitioner - Optometry 0749302255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0003785NYMDOptometrist
P017003785NYMDEyewear Supplier

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascular Specialists PC Past Accepting new patients
Gary Torbey DO PLLC PastSince Jul 3, 2000 Accepting new patients

Organizations & group practices 2

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": "1193616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240531200000",
    "number": "1437338266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 E MAIN ST",
            "address_2": "PO BOX 326",
            "city": "GOUVERNEUR",
            "state": "NY",
            "postal_code": "136421552",
            "telephone_number": "315-287-1644",
            "fax_number": "315-287-4419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 E MAIN ST",
            "city": "GOUVERNEUR",
            "state": "NY",
            "postal_code": "136421552",
            "telephone_number": "315-287-1644",
            "fax_number": "315-287-4419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAIDEL",
        "first_name": "ROBERT",
        "middle_name": "N",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-29",
        "last_updated": "2009-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "0003785",
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NY",
            "license": "P017003785",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00624002",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gouverneur, NY

Sources for this page

Verify at the official NPI Registry.