Costello Sr - Allen Optometrists PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV002717 Issued in NY

Legal business name

COSTELLO SR - ALLEN OPTOMETRISTS PLLC

Doing business as

Allen Eye Associates

Practice address

131 Main St
Suite 202
Oneida, NY 13421-1641

Phone

(315) 363-4942

Fax

(315) 363-4441

NPI assigned

Jan 16, 2009

Last updated

Oct 31, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Matthew C Allen, O.D.NPI 1841369436

Title

Owner

Phone

(315) 363-4942

Specialties & licenses 6

Addresses

Other identifiers 4

Other names 1

• Allen Eye Associates Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew C. Allen, O.D.

  • Optometrist
  • Oneida, NY
  • NPI 1841369436
  Medicare reassignment Care Compare group NPD Authorized official
• Jennifer Musial Cummings, O.D.

  • Optometrist
  • Oneida, NY
  • NPI 1659563658
  Medicare reassignment Care Compare group NPD
• Mark Nelson, OD

  • Optometrist
  • Utica, NY
  • NPI 1669959607
  Medicare reassignment Care Compare group NPD
• Amy Lynn Wardell, OD

  • Optometrist
  • Oneida, NY
  • NPI 1952360166
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1232064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477872000000",
    "number": "1770720468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 MAIN ST",
            "address_2": "SUITE 202",
            "city": "ONEIDA",
            "state": "NY",
            "postal_code": "134211641",
            "telephone_number": "315-363-4942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 MAIN ST",
            "address_2": "SUITE 202",
            "city": "ONEIDA",
            "state": "NY",
            "postal_code": "134211641",
            "telephone_number": "315-363-4942",
            "fax_number": "315-363-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSTELLO SR - ALLEN OPTOMETRISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-16",
        "last_updated": "2016-10-31",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-363-4942",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV002717",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006206",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007184",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006131",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV005917-1",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV008323-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02961255",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02302867",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02924674",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410039620",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Allen Eye Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Zachary Andrew Cook, CASAC-2
• Molly Lynne Coolican, PA-C
• Kristina Cooner
• Corey Corbin, NP
• Costello Eye Physicians & Surgeons, PLLC
• Costello Sr. - Allen Optometrists PLLC
• John J Costello Jr., DO
• Patrick A Costello, MD
• John J. Costello, Sr., O.D.
• Jeffrey Joseph Cottet, COTA

• Optometrist in Oneida, NY
• Providers in Oneida, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.