Individual provider Active NPI

Eric Arayata Samaniego, ABOC

  • Optician
  • Newburgh, NY
National Provider Identifier
1811276439
Registry record updated Aug 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
005867-1 Issued in NY
Practice address
1201 Union Ave
Newburgh, NY 12550-1633
Phone
(845) 567-0068
Fax
(845) 567-3098
NPI assigned
Aug 13, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 005867-1 NY Primary

Addresses

Primary practice location

1201 Union Ave
Newburgh, NY 12550-1633

Mailing address

52 Dogwood Dr
Middletown, NY 10940-1802
Phone (845) 342-8688

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
005867-1NYMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
National Vision, Inc. Past Accepting new patients

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": "1313193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470268800000",
    "number": "1811276439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 DOGWOOD DR",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109401802",
            "telephone_number": "845-342-8688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 UNION AVE",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125501633",
            "telephone_number": "845-567-0068",
            "fax_number": "845-567-3098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMANIEGO",
        "first_name": "ERIC",
        "middle_name": "ARAYATA",
        "name_prefix": "Mr.",
        "credential": "ABOC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-13",
        "last_updated": "2016-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "005867-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2016; 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.