Barry T Kissack, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

VUT004875 Issued in NY

Practice address

7 N Main St
Honeoye Falls, NY 14472-1013

Phone

(585) 624-2585

Fax

(585) 624-3140

NPI assigned

Jun 24, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Southern California College of Optometry, 1967

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: barrykissack@fourcornerseyecare.direct.eyemdemr.com

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.

• Four Corners Optometry, PC

  • Optometrist
  • Honeoye Falls, NY
  • NPI 1326331570
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197417600000",
    "number": "1629074554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 N MAIN ST",
            "address_2": "PO BOX 549",
            "city": "HONEOYE FALLS",
            "state": "NY",
            "postal_code": "144721013",
            "telephone_number": "585-624-2585",
            "fax_number": "585-624-3140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 N MAIN ST",
            "city": "HONEOYE FALLS",
            "state": "NY",
            "postal_code": "144721013",
            "telephone_number": "585-624-2585",
            "fax_number": "585-624-3140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSACK",
        "first_name": "BARRY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2007-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "VUT004875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Marie Jennings, FNP
• Diana Kailburn, LPN
• Brian D Kaufman, D.C.
• Jack David Kerns IX, M.D.
• Sandra E.B. Kerns, RPA-C
• Kendra Grace Knebel
• Jayne E Knowlton, OTD
• Michele Ann Lagana, O.D.
• Brian S Lang, PT
• Audra A Leboo, MBCHB

• Optometrist in Honeoye Falls, NY
• Providers in Honeoye Falls, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.