Active NPI
Dale S Clemens
- Optician
- East Syracuse, NY
National Provider Identifier
1659438455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- C006828
- Practice address
- 824 Franklin Park Dr
East Syracuse, NY 13057-1614 - Phone
- (315) 446-1288
- Fax
- (315) 463-2210
- NPI assigned
- Jan 2, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contact Lens Fitter | 156FC0801X | C006828 | NY | |
| Optician | 156FX1800X | C006828 | NY | Primary |
Addresses
Primary practice location
824 Franklin Park Dr
East Syracuse, NY 13057-1614
Mailing address
824 Franklin Park Dr
East Syracuse, NY 13057-1614
Phone (315) 446-1288
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C006828 | Other | NY | OPHTHALMIC DISPENSING LIC |
| NY6828 | Other | NY | EYEMED PROVIDER NUMBER |
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 |
|---|---|---|---|
| C006828 | NY | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mark Antosh MD PC | Past | Accepting new patients | |
| David M. Girardi, OD, LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Optometrist
- East Syracuse, NY
- NPI 1972916096
-
- Legal Medicine
- East Syracuse, NY
- NPI 1184716888
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309132800000",
"number": "1659438455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "824 FRANKLIN PARK DR",
"city": "EAST SYRACUSE",
"state": "NY",
"postal_code": "130571614",
"telephone_number": "315-446-1288",
"fax_number": "315-463-2210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "824 FRANKLIN PARK DR",
"city": "EAST SYRACUSE",
"state": "NY",
"postal_code": "130571614",
"telephone_number": "315-446-1288",
"fax_number": "315-463-2210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEMENS",
"first_name": "DALE",
"middle_name": "S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-02",
"last_updated": "2011-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "156FC0801X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Contact Lens Fitter",
"state": "NY",
"license": "C006828",
"primary": false
},
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NY",
"license": "C006828",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPHTHALMIC DISPENSING LIC",
"identifier": "C006828",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EYEMED PROVIDER NUMBER",
"identifier": "NY6828",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.