Active NPI
Jonathan David Scroger
- Optician
- Warsaw, NY
National Provider Identifier
1457858763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 005950-1
- Practice address
- 2469 State Route 19 N
Warsaw, NY 14569-9336 - Phone
- (585) 786-8505
- Fax
- (585) 786-8490
- NPI assigned
- Apr 12, 2018
- Last updated
- Apr 12, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 005950-1 | NY | Primary |
Addresses
Primary practice location
2469 State Route 19 N
Warsaw, NY 14569-9336
Mailing address
2469 State Route 19 N
Warsaw, NY 14569-9336
Phone (585) 786-8505
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005950-1 | NY | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523491200000",
"number": "1457858763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2469 STATE ROUTE 19 N",
"city": "WARSAW",
"state": "NY",
"postal_code": "145699336",
"telephone_number": "585-786-8505",
"fax_number": "585-786-8490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2469 STATE ROUTE 19 N",
"city": "WARSAW",
"state": "NY",
"postal_code": "145699336",
"telephone_number": "585-786-8505",
"fax_number": "585-786-8490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCROGER",
"first_name": "JONATHAN",
"middle_name": "DAVID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-12",
"last_updated": "2018-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NY",
"license": "005950-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warsaw, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.