Individual provider Active NPI

Brad C Gollinger, O.D.

  • Optometrist
  • Monroe, NY
National Provider Identifier
1699779678
Registry record updated Oct 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
VUT005741 Issued in NY
Practice address
91 Lakes Rd
Monroe, NY 10950-2613
Phone
(845) 783-1224
Fax
(845) 783-3905
NPI assigned
Jun 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X VUT005741 NY Primary

Addresses

Primary practice location

91 Lakes Rd
Monroe, NY 10950-2613

Mailing address

91 Lakes Rd
Monroe, NY 10950-2613
Phone (845) 783-1224

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
I20050131001063 NY Practitioner - Optometry 7012966146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monroe Family Eyecare Associates, LLPGroup PAC ID 5496704520, 4 clinicians

Practice addresses (Care Compare)

91 Lakes Rd
Suite 1
Monroe, NY 10950-2694
Phone (845) 783-1224

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery50

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005741NYMDClinical Psychologist
VUT005741NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Monroe Family Eyecare Associates, LLP Optometrist CurrentSince Jan 1, 2003 Accepting new patients
Austin Ryan Optical Corp. Optometrist PastSince Nov 1, 2009 Accepting new patients

Locations

91 Lakes Rd
Ste 1
Monroe, NY 10950
Phone (845) 783-1224

91 Lakes Rd
Monroe, NY 10950
Phone (845) 782-8608

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.

NPI Registry JSON

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286496000000",
    "number": "1699779678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 LAKES RD",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109502613",
            "telephone_number": "845-783-1224",
            "fax_number": "845-783-3905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 LAKES RD",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109502613",
            "telephone_number": "845-783-1224",
            "fax_number": "845-783-3905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLLINGER",
        "first_name": "BRAD",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2010-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "VUT005741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NY

Sources for this page

Verify at the official NPI Registry.