Active NPI
Patricia Mary Ebert, LICENSED OPTICIAN
- Optician
- Warwick, NY
National Provider Identifier
1689443541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 010526-01
- Practice address
- 25 Elm Street
Suite 3
Warwick, NY 10990 - Phone
- (845) 987-7333
- Fax
- (845) 986-9040
- NPI assigned
- Dec 20, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 010526-01 | NY | Primary |
Addresses
Primary practice location
25 Elm Street
Suite 3
Warwick, NY 10990
Mailing address
25 Elm Street
Suite 3
Warwick, NY 10990
Phone (845) 987-7333
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 |
|---|---|---|---|
| 010526-01 | NY | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Warwick Optical Inc | Optician | Current | Accepting new patients |
Locations
25 Elm St
Ste 3
Warwick, NY 10990
Phone (845) 987-7333
Organizations & group practices 1
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": "1703030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703030400000",
"number": "1689443541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 ELM STREET",
"address_2": "SUITE 3",
"city": "WARWICK",
"state": "NY",
"postal_code": "10990",
"telephone_number": "845-987-7333",
"fax_number": "845-986-9040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 ELM STREET",
"address_2": "SUITE 3",
"city": "WARWICK",
"state": "NY",
"postal_code": "10990",
"telephone_number": "845-987-7333",
"fax_number": "845-986-9040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBERT",
"first_name": "PATRICIA",
"middle_name": "MARY",
"credential": "LICENSED OPTICIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-12-20",
"last_updated": "2023-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NY",
"license": "010526-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warwick, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.