NPIMap

Organization Active NPI

M B Kayani Physician PC

Doing business as dba Watertown Eye Center

  • Ophthalmology Physician
  • Gouverneur, NY
National Provider Identifier
1801014394
Registry record updated Sep 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
199713 Issued in NY
Legal business name
M B KAYANI PHYSICIAN PC
Doing business as
dba Watertown Eye Center
Practice address
77 W Barney St
Gouverneur, NY 13642-1040
Phone
(315) 287-3638
Fax
(315) 287-3656
NPI assigned
Apr 23, 2007
Last updated
Sep 12, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2013

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

Authorized official

Name
Noaman Sanni, MDNPI 1982654901
Title
Owner
Phone
(315) 788-6070

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 199713 NY Primary
Eyewear Supplier 332H00000X

Addresses

Primary practice location

77 W Barney St
Gouverneur, NY 13642-1040

Mailing address

1815 State St
Watertown, NY 13601-9406
Phone (315) 788-6070

Other names 1

  • dba Watertown Eye Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051011000798 NY Part B Supplier - Clinic/Group Practice 7012932833 Receives reassigned benefits from 10 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lowville, NY; Potsdam, NY; Ogdensburg, NY; Massena, NY; Gouverneur, NY

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

25 Hospital Dr
Massena, NY 13662
Phone (315) 705-6508

301 Ford St
Ogdensburg, NY 13669
Phone (315) 287-3638

Practitioners & affiliated clinicians

Practitioners 11

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": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378944000000",
    "number": "1801014394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 STATE ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136019406",
            "telephone_number": "315-788-6070",
            "fax_number": "315-788-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 W BARNEY ST",
            "city": "GOUVERNEUR",
            "state": "NY",
            "postal_code": "136421040",
            "telephone_number": "315-287-3638",
            "fax_number": "315-287-3656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M B KAYANI PHYSICIAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2013-09-12",
        "status": "A",
        "authorized_official_last_name": "SANNI",
        "authorized_official_first_name": "NOAMAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-788-6070",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "199713",
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba Watertown Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gouverneur, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; 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.