Organization Active NPI

Dr Mark Sorrentino

  • Optometrist
  • Buffalo, NY
National Provider Identifier
1831765668
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DR MARK SORRENTINO
Practice address
403 Main St Ste 510
Buffalo, NY 14203-2107
Phone
(716) 852-7262
Fax
(716) 852-7267
NPI assigned
Jun 2, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Authorized official

Name
Denise Sorrentino
Title
Office Manager
Phone
(716) 536-1179

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

403 Main St Ste 510
Buffalo, NY 14203-2107

Mailing address

403 Main St Ste 510
Buffalo, NY 14203-2107
Phone (716) 852-7262

Other identifiers 1

IdentifierTypeStateIssuer
01906587MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL drsorrentino403@gmail.com Direct

National Provider Directory

National Provider Directory

Locations

403 Main St
Ste 510
Buffalo, NY 14203
Phone (716) 852-7262

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622592000000",
    "number": "1831765668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 MAIN ST STE 510",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142032107",
            "telephone_number": "716-852-7262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 MAIN ST STE 510",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142032107",
            "telephone_number": "716-852-7262",
            "fax_number": "716-852-7267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR MARK SORRENTINO",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A",
        "authorized_official_last_name": "SORRENTINO",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "716-536-1179"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01906587",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "drsorrentino403@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "403 Main St Ste 510",
            "city": "Buffalo",
            "state": "NY",
            "country_code": "US",
            "postal_code": "142032107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Jun 2, 2021; 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.