Individual provider Active NPI

Sara E Thompson, OD

  • Optometrist
  • Staten Island, NY
National Provider Identifier
1780931840
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV009411 Issued in NY
Practice address
260 Christopher LN Ste 102a
Staten Island, NY 10314-1631
Phone
(646) 921-1738
Fax
(315) 612-9793
NPI assigned
Aug 8, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC 4688 FL
Optometrist 152W00000X TUV009411 NY Primary

Addresses

Primary practice location

260 Christopher LN Ste 102a
Staten Island, NY 10314-1631

Mailing address

45 S Route 9W Unit 41 #114
West Haverstraw, NY 10993-1053
Phone (646) 921-1738

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
I20240916002316 NY Practitioner - Optometry 6002357258 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Care Vision Optometry PCGroup PAC ID 2365848165, 32 clinicians

Practice addresses (Care Compare)

918 James St
Syracuse, NY 13203-2503
Phone (646) 921-1738

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 4688FLMDOptometrist
TUV009411NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care Vision Optometry P.C. Optometrist CurrentSince Aug 8, 2024 Accepting new patients

Locations

1526 New Haven Ave
Far Rockaway, NY 11691
Phone (718) 471-7200

260 Christopher Ln
Ste 102A
Staten Island, NY 10314
Phone (914) 370-4892

918 James St
Syracuse, NY 13203
Phone (315) 474-1561

45 S Route 9W
Ste 41
West Haverstraw, NY 10993
Phone (845) 428-9006

Organizations & group practices 1

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": "1344384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1780931840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 S ROUTE 9W UNIT 41 #114",
            "city": "WEST HAVERSTRAW",
            "state": "NY",
            "postal_code": "109931053",
            "telephone_number": "646-921-1738",
            "fax_number": "315-612-9793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 CHRISTOPHER LN STE 102A",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103141631",
            "telephone_number": "646-921-1738",
            "fax_number": "315-612-9793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "SARA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-08",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4688",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV009411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.