Individual provider Active NPI

Allen F Zuck, OD

  • Corneal and Contact Management Optometrist
  • New Hartford, NY
National Provider Identifier
1609857150
Registry record updated Oct 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
TU003939-1 Issued in NY
Practice address
52 New Hartford Shopping Ctr
New Hartford, NY 13413-2144
Phone
(315) 735-7590
Fax
(315) 732-0769
NPI assigned
Nov 10, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Low Vision Rehabilitation Optometrist 152WL0500X TU003939-1 NY
Corneal and Contact Management Optometrist 152WC0802X TU003939-1 NY Primary

Addresses

Primary practice location

52 New Hartford Shopping Ctr
New Hartford, NY 13413-2144

Mailing address

52 New Hartford Shopping Ctr
New Hartford, NY 13413-2144
Phone (315) 735-7590

Other identifiers 1

IdentifierTypeStateIssuer
00489092MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003939NYMDBehavioral Analyst
TU003939-1NYMDLow Vision Rehabilitation Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Association for the Blind and Visually Impaired Past Accepting new patients
Central New York Optometry PLLC Past 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": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288051200000",
    "number": "1609857150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 NEW HARTFORD SHOPPING CTR",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134132144",
            "telephone_number": "315-735-7590",
            "fax_number": "315-732-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 NEW HARTFORD SHOPPING CTR",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134132144",
            "telephone_number": "315-735-7590",
            "fax_number": "315-732-0769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUCK",
        "first_name": "ALLEN",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2010-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "NY",
            "license": "TU003939-1",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NY",
            "license": "TU003939-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00489092",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hartford, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.