Organization Active NPI

Flynn Optometry PLLC

  • Optometrist
  • Pearl River, NY
National Provider Identifier
1457695033
Registry record updated Nov 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5469 Issued in NY
Legal business name
FLYNN OPTOMETRY PLLC
Practice address
275 N Middletown Rd
Suite 2 B
Pearl River, NY 10965-1188
Phone
(845) 735-5757
Fax
(845) 735-5967
NPI assigned
Nov 20, 2012
Last updated
Nov 20, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2012

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

Authorized official

Name
Kathy Crotta
Title
Biller
Phone
(845) 735-5757

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5469 NY Primary

Addresses

Primary practice location

275 N Middletown Rd
Suite 2 B
Pearl River, NY 10965-1188

Mailing address

275 N Middletown Rd
Suite 2 B
Pearl River, NY 10965-1188
Phone (845) 735-5757

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130401000424 NY Part B Supplier - Clinic/Group Practice 7810132446 Receives reassigned benefits from 4 practitioners
Practice locations: Pearl River, NY

National Provider Directory

National Provider Directory

Locations

275 N Middletown Rd
Ste 2B
Pearl River, NY 10965
Phone (845) 735-5757

Practitioners & affiliated clinicians

Practitioners 4

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": "1353369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353369600000",
    "number": "1457695033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 N MIDDLETOWN RD",
            "address_2": "SUITE 2 B",
            "city": "PEARL RIVER",
            "state": "NY",
            "postal_code": "109651188",
            "telephone_number": "845-735-5757",
            "fax_number": "845-735-5967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 N MIDDLETOWN RD",
            "address_2": "SUITE 2 B",
            "city": "PEARL RIVER",
            "state": "NY",
            "postal_code": "109651188",
            "telephone_number": "845-735-5757",
            "fax_number": "845-735-5967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLYNN OPTOMETRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-20",
        "last_updated": "2012-11-20",
        "status": "A",
        "authorized_official_last_name": "CROTTA",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "845-735-5757"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "5469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearl River, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; 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.