Active NPI
Reena Patro, O.D.
- Optometrist
- Ithaca, NY
National Provider Identifier
1740695295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TUV009240
- Practice address
- 106 Dryden Rd
Ithaca, NY 14850 - Phone
- (607) 273-1234
- NPI assigned
- Jun 24, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 8463T | TX | |
| Optometrist | 152W00000X | TUV009240 | NY | Primary |
Addresses
Primary practice location
106 Dryden Rd
Ithaca, NY 14850
Mailing address
131 E Green St Apt 415
Ithaca, NY 14850-5657
Phone (972) 365-6595
Other practice location 1
748 S Meadow St
Ithaca, NY 14850-5374
Phone (607) 330-9004
Other practice location 2
3190 S Central Expy
McKinney, TX 75070-4500
Phone (214) 504-2271
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TUV009240 | NY | MD | Optometrist |
| 8463T | TX | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edward G Bryant IV OD PLLC | Optometrist | Current | Accepting new patients |
| National Vision Inc | Past | Accepting new patients |
Locations
106 Dryden Rd
Ithaca, NY 14850
Phone (607) 273-1234
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": "1403568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618272000000",
"number": "1740695295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "131 E GREEN ST APT 415",
"city": "ITHACA",
"state": "NY",
"postal_code": "148505657",
"telephone_number": "972-365-6595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 DRYDEN RD",
"city": "ITHACA",
"state": "NY",
"postal_code": "14850",
"telephone_number": "607-273-1234"
}
],
"practiceLocations": [
{
"address_1": "748 S Meadow St",
"address_purpose": "LOCATION",
"city": "Ithaca",
"state": "NY",
"postal_code": "148505374",
"country_code": "US",
"telephone_number": "607-330-9004",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3190 S Central Expy",
"address_purpose": "LOCATION",
"city": "McKinney",
"state": "TX",
"postal_code": "750704500",
"country_code": "US",
"telephone_number": "214-504-2271",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PATRO",
"first_name": "REENA",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-24",
"last_updated": "2021-04-13",
"certification_date": "2021-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "8463T",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "TUV009240",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ithaca, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.