Individual provider Active NPI

James A McDonel, O.D.

  • Optometrist
  • Buffalo, NY
National Provider Identifier
1629119797
Registry record updated Mar 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV007141-1 Issued in NY
Practice address
1176 Main St
Buffalo, NY 14209-2102
Phone
(716) 881-7900
Fax
(716) 887-2990
NPI assigned
Feb 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4214T78 OH
Optometrist 152W00000X TUV007141-1 NY Primary

Addresses

Primary practice location

1176 Main St
Buffalo, NY 14209-2102

Mailing address

1176 Main St
Buffalo, NY 14209-2102
Phone (716) 881-7900

Other identifiers 4

IdentifierTypeStateIssuer
2220272OtherUNITED HEALTH CARE
0901224MedicaidOH
000000006965OtherANTHEM
02911700MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150318002667 VA Practitioner - Optometry 3476625534 Reassigns benefits to 1 organization
I20240228003025 FL Practitioner - Optometry 3476625534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes at the Villages PAGroup PAC ID 5294987905, 16 clinicians

Practice addresses (Care Compare)

1050 Old Camp Rd
Suite 230
The Villages, FL 32162-1762
Phone (352) 350-8484

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
4214OHMDChiropractor
TUV007141-1NYMDOptometrist
4214T78OHMDOptometrist
007141NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
NRV Eye Center, Inc CurrentSince Mar 1, 2016 Accepting new patients
St . Lukes at the Villages, PA Optometrist CurrentSince Feb 23, 2024 Accepting new patients
NK Optical, LLC Past Accepting new patients

Locations

43309 US Highway 19 N
Tarpon Springs, FL 34689
Phone (727) 938-2020

2955 Brownwood Blvd
Ste 303
The Villages, FL 32163
Phone (352) 350-8484

1050 Old Camp Rd
Ste 230
The Villages, FL 32162
Phone (352) 350-8484

106 S Franklin St
Ste C
Christiansburg, VA 24073
Phone (540) 381-2013

310 E Main St
Wytheville, VA 24382
Phone (276) 228-2771

Interoperability endpoints

  • Direct secure messaging: james.mcdonel.p3@direct.stlukeseye.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: james.mcdonelod.p1@direct.stlukeseye.nextgenshare.com

Organizations & group practices 3

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": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331078400000",
    "number": "1629119797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1176 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142092102",
            "telephone_number": "716-881-7900",
            "fax_number": "716-887-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1176 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142092102",
            "telephone_number": "716-881-7900",
            "fax_number": "716-887-2990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONEL",
        "first_name": "JAMES",
        "middle_name": "A",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2012-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4214T78",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007141-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "2220272",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0901224",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000006965",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02911700",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.