Individual provider Active NPI

Joseph Ditota, O.D.

  • Optometrist
  • Syracuse, NY
National Provider Identifier
1730258575
Registry record updated Feb 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
VUT007004 Issued in NY
Practice address
2901 Court St
Syracuse, NY 13208-3217
Phone
(315) 455-8933
Fax
(315) 455-8934
NPI assigned
Nov 7, 2006
Last updated
Feb 23, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X VUT007004 NY Primary

Addresses

Primary practice location

2901 Court St
Syracuse, NY 13208-3217

Mailing address

7774 Deerfield Rd
Liverpool, NY 13090-2308
Phone (315) 455-8933

Other identifiers 2

IdentifierTypeStateIssuer
161512570OtherNYTAX ID #
50743OtherNYBLUE CROSS

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
I20060316000536 NY Practitioner - Optometry 2769499698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ehsoc IncGroup PAC ID 3779530407, 4 clinicians

Practice addresses (Care Compare)

2901 Court St
Syracuse, NY 13208-3217
Phone (315) 455-8933

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
VUT007004NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ehsoc Optometrist PastSince May 18, 2009 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235347200000",
    "number": "1730258575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7774 DEERFIELD RD",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130902308",
            "telephone_number": "315-455-8933",
            "fax_number": "315-455-8934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 COURT ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132083217",
            "telephone_number": "315-455-8933",
            "fax_number": "315-455-8934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITOTA",
        "first_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2009-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "VUT007004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "161512570",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "50743",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.