Organization Active NPI

Park Sher Optical Co of Buffalo Ny Inc

  • Optometrist
  • Williamsville, NY
National Provider Identifier
1629376942
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
PARK SHER OPTICAL CO OF BUFFALO NY INC
Practice address
5350 Main St
Williamsville, NY 14221-5338
Phone
(716) 631-3820
NPI assigned
Mar 10, 2011
Last updated
Sep 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Authorized official

Name
Robert Jude Joba
Title
OD
Phone
(716) 947-2462

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 3383-1 NY
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

5350 Main St
Williamsville, NY 14221-5338

Mailing address

5350 Main St
Williamsville, NY 14221-5338
Phone (716) 631-3820

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220114000228 NY Part B Supplier - Clinic/Group Practice 3476831777 Receives reassigned benefits from 18 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Williamsville, NY; West Seneca, NY; Webster, NY; Tonawanda, NY; Rochester, NY; Lackawanna, NY; Lockport, NY; Buffalo, NY…

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1299715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758067200000",
    "number": "1629376942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5350 MAIN ST",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215338",
            "telephone_number": "716-631-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5350 MAIN ST",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215338",
            "telephone_number": "716-631-3820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK SHER OPTICAL CO OF BUFFALO NY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-10",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A",
        "authorized_official_last_name": "JOBA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JUDE",
        "authorized_official_title_or_position": "OD",
        "authorized_official_telephone_number": "716-947-2462"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NY",
            "license": "3383-1",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2025; 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.