Individual provider Active NPI

Lauren A Wolitzer, O.D.

  • Optometrist
  • New York, NY
National Provider Identifier
1699115980
Registry record updated Dec 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV008008 Issued in NY
Practice address
210 W 79TH St
New York, NY 10024-6228
Phone
(212) 877-5840
Fax
(212) 877-5841
NPI assigned
Jul 1, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV008008 NY Primary

Addresses

Primary practice location

210 W 79TH St
New York, NY 10024-6228

Mailing address

210 W 79TH St
New York, NY 10024-6228
Phone (212) 877-5840

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20131016000358 NY Practitioner - Optometry 3870727308

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

210 W 79TH St
New York, NY 10024-6228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008008NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gary Tracy, OD P.C. Optometrist CurrentSince Dec 14, 2020 Accepting new patients

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": "1372636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1699115980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W 79TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100246228",
            "telephone_number": "212-877-5840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W 79TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100246228",
            "telephone_number": "212-877-5840",
            "fax_number": "212-877-5841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLITZER",
        "first_name": "LAUREN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-01",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV008008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.