Active NPI
Joseph Osborn, OPHTHALMIC DISPENSER
- Optician
- Clifton Park, NY
National Provider Identifier
1609996008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 006910-1
- Practice address
- 1789 Route 9
Clifton Park, NY 12065-2438 - Phone
- (518) 371-0246
- Fax
- (518) 383-9888
- NPI assigned
- Mar 30, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 006910-1 | NY | Primary |
Addresses
Primary practice location
1789 Route 9
Clifton Park, NY 12065-2438
Mailing address
49 Route 67
Mechanicville, NY 12118-3209
Phone (518) 541-2788
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1172880001 | Other | NY | DME SUPPLIER |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006910-1 | NY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202774400000",
"number": "1609996008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "49 ROUTE 67",
"city": "MECHANICVILLE",
"state": "NY",
"postal_code": "121183209",
"telephone_number": "518-541-2788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1789 ROUTE 9",
"city": "CLIFTON PARK",
"state": "NY",
"postal_code": "120652438",
"telephone_number": "518-371-0246",
"fax_number": "518-383-9888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OSBORN",
"first_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "OPHTHALMIC DISPENSER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-30",
"last_updated": "2008-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NY",
"license": "006910-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DME SUPPLIER",
"identifier": "1172880001",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clifton Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.