Organization Active NPI

Warsaw Opticians, Inc .

  • Optician
  • Warsaw, NY
National Provider Identifier
1619037256
Registry record updated Feb 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
C004826-1 Issued in NY
Legal business name
WARSAW OPTICIANS, INC .
Practice address
2447 State Route 19 N
Warsaw, NY 14569-9336
Phone
(585) 786-5075
NPI assigned
Dec 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2008

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

Authorized official

Name
Mr. Daniel F Nowak, OPTICIAN
Title
Owner
Phone
(585) 786-5075

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X C004826-1 NY Primary

Addresses

Primary practice location

2447 State Route 19 N
Warsaw, NY 14569-9336

Mailing address

2447 State Route 19 N
Warsaw, NY 14569-9336
Phone (585) 786-5075

Other identifiers 5

IdentifierTypeStateIssuer
00963204MedicaidNY
7311143OtherNYINDEPENDENT HEALTH
NY4826OtherNYEYEMED
0027036801OtherNYUNIVERA
103131CTOtherNYPREFERRED CARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040818001039 NY Part B Supplier - Clinic/Group Practice 3678546496 Receives reassigned benefits from 1 practitioner
Practice locations: Warsaw, NY

National Provider Directory

National Provider Directory

Locations

2447 State Route 19 N
Warsaw, NY 14569
Phone (585) 786-5075

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203552000000",
    "number": "1619037256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2447 STATE ROUTE 19 N",
            "city": "WARSAW",
            "state": "NY",
            "postal_code": "145699336",
            "telephone_number": "585-786-5075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2447 STATE ROUTE 19 N",
            "city": "WARSAW",
            "state": "NY",
            "postal_code": "145699336",
            "telephone_number": "585-786-5075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARSAW OPTICIANS, INC .",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2008-02-21",
        "status": "A",
        "authorized_official_last_name": "NOWAK",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "585-786-5075",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OPTICIAN"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "C004826-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00963204",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "7311143",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "NY4826",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "0027036801",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "103131CT",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warsaw, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.