Individual provider Active NPI

Adonya Blair, O.D.

  • Optometrist
  • New York, NY
National Provider Identifier
1508979170
Registry record updated Mar 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV007256 Issued in NY
Practice address
110 E 55TH St
New York, NY 10022-4540
Phone
(212) 759-9617
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV007256 NY Primary

Addresses

Primary practice location

110 E 55TH St
New York, NY 10022-4540

Mailing address

110 E 55TH St
New York, NY 10022-4540

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
I20200731001036 NY Practitioner - Optometry 1658323449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

88 Dunning Rd
Suite 6
Middletown, NY 10940-2220
Phone (845) 692-5800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007256NYMDChiropractor
TUV007256NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal Clear Vision Corp. Optometrist CurrentSince Jun 1, 2020 Accepting new patients
Professional Eyecare Zona Rosa Inc. Optometrist Past Accepting new patients
Professional Eyecare - Bannister Optometrist Past Accepting new patients
Adonya Blair, O.D., P.C. Optometrist PastSince Feb 7, 2007 Accepting new patients
Professional Eyecare Metro North Inc Optometrist Past Accepting new patients
Professional Eyecare Management Inc. Optometrist Past Accepting new patients

Locations

1101 Amboy Ave
Edison, NJ 08837
Phone (718) 477-6700

88 Dunning Rd
Ste 6
Middletown, NY 10940
Phone (845) 692-5800

Organizations & group practices 6

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394150400000",
    "number": "1508979170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E 55TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100224540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E 55TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100224540",
            "telephone_number": "212-759-9617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "ADONYA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2014-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.