Individual provider Active NPI

Laura Puccia, OD

  • Optometrist
  • Webster, NY
National Provider Identifier
1760091565
Registry record updated Jul 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
009209 Issued in NY
Practice address
1015 Ridge Rd
Webster, NY 14580-2907
Phone
(585) 872-4394
Fax
(585) 872-9035
NPI assigned
Jul 28, 2020
Last updated
Jul 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 009209 NY Primary

Addresses

Primary practice location

1015 Ridge Rd
Webster, NY 14580-2907

Mailing address

1015 Ridge Rd
Webster, NY 14580-2907
Phone (585) 872-4394

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
I20201111001010 NY Practitioner - Optometry 9931519543 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Physicians and Surgeons of Western New York PLLCGroup PAC ID 0840240941, shared by 5 NPIs, 12 clinicians

Practice addresses (Care Compare)

1015 Ridge Rd
Webster, NY 14580-2907

919 Westfall Rd
BLDG a Suite 205
Rochester, NY 14618-2638

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Physicians and Surgeons of Western New York PLLC Optometrist CurrentSince Oct 1, 2020 Accepting new patients
Eye Physicians and Surgeons of Western New York PLLC Optometrist CurrentSince Oct 1, 2020 Accepting new patients
Eye Physicians and Surgeons of Western New York PLLC Optometrist Current Accepting new patients
Eye Physicians and Surgeons of Western New York PLLC Past Accepting new patients

Locations

2 Greece Center Dr
Rochester, NY 14612
Phone (585) 225-7060

919 Westfall Rd
Ste A205
Rochester, NY 14618
Phone (585) 244-2580

1015 Ridge Rd
Webster, NY 14580
Phone (585) 244-2580

Organizations & group practices 4

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": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1760091565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 RIDGE RD",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145802907",
            "telephone_number": "585-872-4394",
            "fax_number": "585-872-9035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 RIDGE RD",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145802907",
            "telephone_number": "585-872-4394",
            "fax_number": "585-872-9035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCCIA",
        "first_name": "LAURA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-28",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "009209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, NY

Sources for this page

Verify at the official NPI Registry.