NPIMap

Organization Active NPI

Susquehanna Eye Care

Doing business as Sacco Eye Group

  • Optometrist
  • Vestal, NY
National Provider Identifier
1780756601
Registry record updated Jan 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T5275-1 Issued in NY
Legal business name
SUSQUEHANNA EYE CARE
Doing business as
Sacco Eye Group
Practice address
3209 Vestal Pkwy E
Suite C
Vestal, NY 13850-2154
Phone
(607) 798-1987
Fax
(607) 729-8277
NPI assigned
Nov 15, 2006
Last updated
Jan 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2008

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

Authorized official

Name
Dr. Andrew J Sacco, ODNPI 1588638597
Title
Owner
Phone
(607) 798-1987

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T5275-1 NY Primary

Addresses

Primary practice location

3209 Vestal Pkwy E
Suite C
Vestal, NY 13850-2154

Mailing address

3209 Vestal Pkwy E
Vestal, NY 13850-2154
Phone (607) 798-1987

Other names 1

  • Sacco Eye Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040908000473 NY Part B Supplier - Clinic/Group Practice 3577539816 Receives reassigned benefits from 2 practitioners
Practice locations: Vestal, NY
O20100930011602 NY DME Supplier - Physician - OptometristDME Supplier - Optician 3577539816 Practice locations: Vestal, NY

National Provider Directory

National Provider Directory

Locations

3209 Vestal Pkwy E
Ste C
Vestal, NY 13850
Phone (607) 798-1987

400 Plaza Dr
Ste B
Vestal, NY 13850
Phone (607) 798-1987

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200528000000",
    "number": "1780756601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3209 VESTAL PKWY E",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138502154",
            "telephone_number": "607-798-1987",
            "fax_number": "607-729-8277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3209 VESTAL PKWY E",
            "address_2": "SUITE C",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138502154",
            "telephone_number": "607-798-1987",
            "fax_number": "607-729-8277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSQUEHANNA EYE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2008-01-17",
        "status": "A",
        "authorized_official_last_name": "SACCO",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "607-798-1987",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "T5275-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sacco Eye Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vestal, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.