Antoniette Thavarajah, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

009448 Issued in NY

Practice address

2810 Sheridan Dr
Tonawanda, NY 14150-9419

Phone

(716) 834-6000

NPI assigned

Sep 7, 2021

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Empire Vision Center Inc

  • Optometrist
  • Syracuse, NY
  • NPI 1750358826
  Medicare reassignment NPD
• Empire Vision Center, Inc

  • Eyewear Supplier
  • Attleboro, MA
  • NPI 1730635582
  NPD
• America'S Best Contacts & Eyeglasses

  • Eyewear Supplier
  • Tonawanda, NY
  • NPI 1144251844
  NPD (past)

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

{
    "created_epoch": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630972800000",
    "number": "1689343477",
    "addresses": [
        {
            "country_code": "CA",
            "country_name": "Canada",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "6 PEBBLESTONE CIRCLE",
            "city": "BRAMPTON",
            "state": "ONTARIO",
            "postal_code": "L6X4M3"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 SHERIDAN DR",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141509419",
            "telephone_number": "716-834-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAVARAJAH",
        "first_name": "ANTONIETTE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-07",
        "last_updated": "2021-09-07",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "009448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ericka Taplin
• Amy Beth Taublieb, PH.D.
• Robyn Taylor
• Danielle H Tedesco, M.A.
• Joseph S. Testa, M.D.
• The Foot & Ankle Podiatry,PC
• The Foot and Ankle Podiatry PC
• Cynthia Thiebolt
• Thomas J Davidson IV Wny LLC
• Jacinda Thomas, MSW

• Optometrist in Tonawanda, NY
• Providers in Tonawanda, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.