Individual provider Active NPI

Debra Anne Koloms, MD

  • Ophthalmology Physician
  • Watertown, NY
National Provider Identifier
1770533515
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
206048 Issued in NY
Practice address
1815 State St
Watertown, NY 13601-9406
Phone
(315) 788-6070
Fax
(315) 788-1950
NPI assigned
May 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 206048 NY Primary

Addresses

Primary practice location

1815 State St
Watertown, NY 13601-9406

Mailing address

1815 State St
Watertown, NY 13601-9406
Phone (315) 788-6070

Other identifiers 1

IdentifierTypeStateIssuer
01753204MedicaidNY

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110419000053 NY Practitioner - Ophthalmology 3678757556 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Loyola University of Chicago, Stritch School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
M B Kayani Physician PCGroup PAC ID 7012932833, 5 clinicians

Practice addresses (Care Compare)

1815 State St
Watertown, NY 13601-9407

7785 N State St
Lowville, NY 13367-1229
Phone (315) 376-5102

Hospital & facility affiliations

  • Samaritan Medical Center Hospital, Watertown, NY, CCN 330157
  • Carthage Area Hospital, Inc Hospital, Ogdensburg, NY, CCN 331324
  • Lewis County General Hospital Hospital, Lowville, NY, CCN 331317

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery184

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
M B Kayani Physician PC Ophthalmology CurrentSince Jun 30, 1997 Accepting new patients
River Hospital, Inc. CurrentSince Dec 12, 2012 Accepting new patients
River Hospital, Inc. CurrentSince Dec 12, 2012 Accepting new patients
M B Kayani Physician PC Ophthalmology CurrentSince Jun 30, 1997 Accepting new patients

Locations

4 Fuller St
Alexandria Bay, NY 13607
Phone (315) 482-1277

77 W Barney St
Gouverneur, NY 13642
Phone (315) 287-1000

7785 N State St
Lowville, NY 13367
Phone (315) 376-5102

420 Ford St
Ogdensburg, NY 13669
Phone (315) 393-7171

1815 State St
Watertown, NY 13601
Phone (315) 786-8064

830 Washington St
Watertown, NY 13601
Phone (315) 785-4000

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 and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1770533515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 STATE ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136019406",
            "telephone_number": "315-788-6070",
            "fax_number": "315-788-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 STATE ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136019406",
            "telephone_number": "315-788-6070",
            "fax_number": "315-788-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLOMS",
        "first_name": "DEBRA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "206048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01753204",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

Verify at the official NPI Registry.