Individual provider Active NPI

Thomas Russell Cherre, OPTICIAN

  • Optician
  • Buffalo, NY
National Provider Identifier
1780959064
Registry record updated Mar 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
C003383-1 Issued in NY
Practice address
280 Delaware Ave
Buffalo, NY 14202-1801
Phone
(716) 854-1620
Fax
(716) 854-1623
NPI assigned
Mar 20, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X C003383-1 NY Primary

Addresses

Primary practice location

280 Delaware Ave
Buffalo, NY 14202-1801

Mailing address

280 Delaware Ave
Buffalo, NY 14202-1801
Phone (716) 854-1620

Other identifiers 1

IdentifierTypeStateIssuer
160367410MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C003383-1NYMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1332201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332201600000",
    "number": "1780959064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 DELAWARE AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142021801",
            "telephone_number": "716-854-1620",
            "fax_number": "716-854-1623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 DELAWARE AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142021801",
            "telephone_number": "716-854-1620",
            "fax_number": "716-854-1623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERRE",
        "first_name": "THOMAS",
        "middle_name": "RUSSELL",
        "name_prefix": "Mr.",
        "credential": "OPTICIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-20",
        "last_updated": "2012-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "C003383-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160367410",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.