Individual provider Active NPI

Gretchen R Spittler, OD

  • Optometrist
  • Plattsburgh, NY
National Provider Identifier
1548311129
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV0054541 Issued in NY
Practice address
224 Tom Miller Rd
Plattsburgh, NY 12901
Phone
(518) 561-7170
Fax
(518) 561-6129
NPI assigned
Jan 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV0054541 NY Primary

Addresses

Primary practice location

224 Tom Miller Rd
Plattsburgh, NY 12901

Mailing address

224 Tom Miller Rd
Plattsburgh, NY 12901
Phone (518) 561-7170

Other identifiers 2

IdentifierTypeStateIssuer
01649265MedicaidNY
01440642MedicaidNY

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
I20080415000513 NY Practitioner - Optometry 2668550708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

224 Tom Miller Rd
Plattsburgh, NY 12901-6427
Phone (518) 561-7170

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV0054541NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
H Ryder Inc PastSince May 9, 2008 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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1548311129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 TOM MILLER RD",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "12901",
            "telephone_number": "518-561-7170",
            "fax_number": "518-561-6129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 TOM MILLER RD",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "12901",
            "telephone_number": "518-561-7170",
            "fax_number": "518-561-6129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPITTLER",
        "first_name": "GRETCHEN",
        "middle_name": "R",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV0054541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01649265",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01440642",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plattsburgh, NY

Sources for this page

Verify at the official NPI Registry.