Individual provider Active NPI

Andrea Kaiser, OD

  • Optometrist
  • Thornwood, NY
National Provider Identifier
1578600938
Registry record updated Jun 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
NY5840 Issued in NY
Practice address
660 Columbus Ave
Thornwood, NY 10594-1909
Phone
(914) 747-2000
Fax
(914) 747-4032
NPI assigned
Feb 1, 2007
Last updated
Jun 11, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NY5840 NY Primary

Addresses

Primary practice location

660 Columbus Ave
Thornwood, NY 10594-1909

Mailing address

660 Columbus Ave
3-3
Thornwood, NY 10594-1909
Phone (914) 747-2000

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
I20110121000498 NY Practitioner - Optometry 7214133578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1997
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

660 Columbus Ave
Thornwood, NY 10594-1909
Phone (914) 747-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NY5840NYMDOptometrist

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": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307750400000",
    "number": "1578600938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 COLUMBUS AVE",
            "address_2": "3-3",
            "city": "THORNWOOD",
            "state": "NY",
            "postal_code": "105941909",
            "telephone_number": "914-747-2000",
            "fax_number": "914-747-4032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 COLUMBUS AVE",
            "city": "THORNWOOD",
            "state": "NY",
            "postal_code": "105941909",
            "telephone_number": "914-747-2000",
            "fax_number": "914-747-4032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAISER",
        "first_name": "ANDREA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2011-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "NY5840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornwood, NY

Sources for this page

Verify at the official NPI Registry.