Individual provider Active NPI

Jason D Ogonowski, O.D.

  • Optometrist
  • Troy, NY
National Provider Identifier
1770637845
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV8372-1 Issued in NY
Practice address
42 3Rd St
Troy, NY 12180-3906
Phone
(518) 274-8181
Fax
(518) 272-8164
NPI assigned
Jan 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC003927 FL
Optometrist 152W00000X TUV8372-1 NY Primary

Addresses

Primary practice location

42 3Rd St
Troy, NY 12180-3906

Mailing address

42 3Rd Street
Troy, NY 12180-3906
Phone (518) 274-8181

Other identifiers 1

IdentifierTypeStateIssuer
04268902MedicaidNY

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
I20161102002542 NY Practitioner - Optometry 9537147210 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

42 3Rd St
Troy, NY 12180-3906
Phone (518) 274-8181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC003927FLMDOptometrist
TUV8372-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Troy Optical LTD Optometrist CurrentSince Sep 1, 2016 Accepting new patients
Thomas K. Wilcox, O.D. and Associates, P.C. Past Accepting new patients
Sidney J Stern Visual Health Centers PA Optometrist Past Accepting new patients

Locations

42 3rd St
Troy, NY 12180
Phone (518) 274-8181

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.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1770637845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 3RD STREET",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121803906",
            "telephone_number": "518-274-8181",
            "fax_number": "518-272-8164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 3RD ST",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121803906",
            "telephone_number": "518-274-8181",
            "fax_number": "518-272-8164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGONOWSKI",
        "first_name": "JASON",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC003927",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV8372-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04268902",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, NY

Sources for this page

Verify at the official NPI Registry.