Individual provider Active NPI

Jessica Maher, OD

  • Optometrist
  • New Windsor, NY
National Provider Identifier
1568071454
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
009193 Issued in NY
Practice address
140 Executive Dr
New Windsor, NY 12553-5551
Phone
(845) 562-0138
NPI assigned
Jul 27, 2020
Last updated
Feb 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 009193 NY Primary

Addresses

Primary practice location

140 Executive Dr
New Windsor, NY 12553-5551

Mailing address

140 Executive Dr
Ste 300
New Windsor, NY 12553-5551
Phone (845) 562-0138

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
I20201016000484 NY Practitioner - Optometry 1951721745 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Highland Ophthalmology Associates LLCGroup PAC ID 4284526203, 5 clinicians

Practice addresses (Care Compare)

140 Executive Dr
New Windsor, NY 12553-5509

140 Executive Dr
New Windsor, NY 12553-5551
Phone (845) 562-0138

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009193NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Ophthalmology Associates LLC CurrentSince Sep 14, 2020 Accepting new patients

Locations

140 Executive Dr
New Windsor, NY 12553
Phone (845) 562-0138

140 Executive Dr
Ste 300
New Windsor, NY 12553
Phone (845) 562-0138

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1568071454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 EXECUTIVE DR",
            "address_2": "STE 300",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "125535551",
            "telephone_number": "845-562-0138",
            "fax_number": "845-562-0147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 EXECUTIVE DR",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "125535551",
            "telephone_number": "845-562-0138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHER",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-27",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "009193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Windsor, NY

Sources for this page

Verify at the official NPI Registry.