Individual provider Active NPI

Brittany Taylor Neudecker, OD

  • Optometrist
  • Liverpool, NY
National Provider Identifier
1497447486
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
RT009917-01 Issued in NY
Practice address
3873 State Route 31 Ste 110
Liverpool, NY 13090-1489
Phone
(315) 652-5962
NPI assigned
May 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X RT009917-01 NY Primary

Addresses

Primary practice location

3873 State Route 31 Ste 110
Liverpool, NY 13090-1489

Mailing address

3372 Longview Ter
Baldwinsville, NY 13027-4306
Phone (256) 596-0278

Other practice location 1

5653 E Circle Dr
Cicero, NY 13039-8741
Phone (315) 458-1216

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
I20231211001227 NY Practitioner - Optometry 9739548272 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
RT009917-01NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Empire Vision Center, Inc CurrentSince Nov 8, 2023 Accepting new patients
Empire Vision Center Inc Optometrist CurrentSince Nov 8, 2023 Accepting new patients

Locations

2680 Delaware Ave
Ste C
Buffalo, NY 14216
Phone (716) 873-1241

5653 E Circle Dr
Cicero, NY 13039
Phone (315) 458-1216

560 Troy Schenectady Rd
#7
Latham, NY 12110
Phone (518) 783-0090

3873 State Route 31
Ste 110
Liverpool, NY 13090
Phone (315) 652-5961

1930 South Rd
#105
Poughkeepsie, NY 12601
Phone (845) 298-3200

2590 W Ridge Rd
Rochester, NY 14626
Phone (585) 227-7150

2921 Erie Blvd E
Syracuse, NY 13224
Phone (315) 446-3145

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": "1684972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743724800000",
    "number": "1497447486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3372 LONGVIEW TER",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130274306",
            "telephone_number": "256-596-0278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3873 STATE ROUTE 31 STE 110",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130901489",
            "telephone_number": "315-652-5962"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5653 E Circle Dr",
            "address_purpose": "LOCATION",
            "city": "Cicero",
            "state": "NY",
            "postal_code": "130398741",
            "country_code": "US",
            "telephone_number": "315-458-1216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEUDECKER",
        "first_name": "BRITTANY",
        "middle_name": "TAYLOR",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-25",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "RT009917-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

Verify at the official NPI Registry.