Joseph P Gambacorta, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV004897-2 Issued in NY

Practice address

5500 Main St Ste 102
Williamsville, NY 14221-6737

Phone

(716) 833-2020

Fax

(716) 833-3854

NPI assigned

Apr 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

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

Specialty

Optometry

Education

New England College of Optometry, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

200 West Optics LLCGroup PAC ID 5395144380, 38 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: direct@eyecareprofessionalsofwnyamherstny.compulinkdirect.com

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.

• 200 West Optics, LLC

  • Optometrist
  • Brewster, NY
  • NPI 1831770890
  Medicare reassignment Care Compare group NPD
• Eye Care Professionals of Western New York, LLP

  • Optometrist
  • Depew, NY
  • NPI 1619194115
  Medicare reassignment NPD
• 200 West Optics, LLC

  • Optometrist
  • New York, NY
  • NPI 1205787520
  NPD
• 200 West Optics, LLC

  • Optometrist
  • Brooklyn, NY
  • NPI 1942050257
  NPD
• Eye Care Professionals of Western New York LLP

  • Optometrist
  • Williamsville, NY
  • NPI 1780235663
  NPD
• Eye Care Professionals of Wny

  • Optometrist
  • Buffalo, NY
  • NPI 1609020148
  NPD (past)

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1730142498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3364 SHERIDAN DR",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261439",
            "telephone_number": "716-833-2020",
            "fax_number": "716-833-3854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 MAIN ST STE 102",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216737",
            "telephone_number": "716-833-2020",
            "fax_number": "716-833-3854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBACORTA",
        "first_name": "JOSEPH",
        "middle_name": "P",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV004897-2",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00010207803",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01089101",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Direct@EyeCareProfessionalsOfWNYAmherstNY.CompulinkDirect.com",
            "affiliation": "N",
            "address_1": "5500 Main St Ste 102",
            "city": "Williamsville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "142216737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Conor Gallivan, PA
• Derek Anthony Gallucci, D.O.
• Alexandria Carcyn Galluzzi, PA-C
• Dennis C Galluzzo, R.PH.
• Terra Galvano, DNP
• Katherine Anne Gambacorta, D.O.
• Sharon Alexandra Ganatra, PHARM D
• Efren Gancena, RN
• Brittany Gandy
• Sheila Gannon, LPN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.