Individual provider Active NPI

Roy A Kline, O.D.

  • Optometrist
  • Lake Katrine, NY
National Provider Identifier
1841254125
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV003653-1 Issued in NY
Practice address
1636 Ulster Ave
Lake Katrine, NY 12449-5420
Phone
(845) 336-6310
Fax
(845) 336-8573
NPI assigned
Apr 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV003653-1 NY Primary

Addresses

Primary practice location

1636 Ulster Ave
Lake Katrine, NY 12449-5420

Mailing address

11 Shallow Creek Rd
Queensbury, NY 12804-1040
Phone (518) 796-6612

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
I20110310000940 NY Practitioner - Optometry 5092772996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
37 of 100Reported as group
Quality
40
Promoting interoperability
0
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV003653-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Roy Kline Optometry PLLC Optometrist CurrentSince Sep 30, 2025 Accepting new patients
Hudson Valley Vision Center Inc. Optometrist CurrentSince Oct 21, 2025 Accepting new patients

Locations

1636 Ulster Ave
Lake Katrine, NY 12449
Phone (845) 336-6310

Organizations & group practices 2

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1841254125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 SHALLOW CREEK RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128041040",
            "telephone_number": "518-796-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1636 ULSTER AVE",
            "city": "LAKE KATRINE",
            "state": "NY",
            "postal_code": "124495420",
            "telephone_number": "845-336-6310",
            "fax_number": "845-336-8573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINE",
        "first_name": "ROY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV003653-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Katrine, NY

Sources for this page

Verify at the official NPI Registry.