Watertown Medical Optical PLLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

WATERTOWN MEDICAL OPTICAL PLLC

Doing business as

Noaman Sanni dba Watertown Medical Optical PLLC

Practice address

1815 State Street
Watertown, NY 13601

Phone

(315) 786-8064

Fax

(315) 788-1950

NPI assigned

Mar 19, 2007

Last updated

Apr 15, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Noaman Sanni, MDNPI 1982654901

Title

Owner

Phone

(315) 788-6070

Specialties & licenses 4

Addresses

Other names 1

• Noaman Sanni dba Watertown Medical Optical PLLC Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Watertown Medical Optical PLLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Watertown Medical Optical PLLC

  • Eyewear Supplier
  • Ogdensburg, NY
  • NPI 1073076725
  NPD tax ID
• Watertown Medical Optical PLLC

  • Eyewear Supplier
  • Gouverneur, NY
  • NPI 1407319155
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Noaman Sanni, MD

  • Ophthalmology Physician
  • Watertown, NY
  • NPI 1982654901
  NPD (past) Authorized official

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365984000000",
    "number": "1730203548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 STATE STREET",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "13601",
            "telephone_number": "315-786-8064",
            "fax_number": "315-788-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 STATE STREET",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "13601",
            "telephone_number": "315-786-8064",
            "fax_number": "315-788-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERTOWN MEDICAL OPTICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2013-04-15",
        "status": "A",
        "authorized_official_last_name": "SANNI",
        "authorized_official_first_name": "NOAMAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-788-6070",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "VUT0053871",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "2060481",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Noaman Sanni dba Watertown Medical Optical PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Eyewear Supplier in Watertown, NY
• Providers in Watertown, NY by specialty
• Eyewear Supplier in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.