NPIMap

Organization Active NPI

Steve B. Park M.D. PC

Doing business as Cornerstone Eye Associates

  • Eyewear Supplier
  • Rochester, NY
National Provider Identifier
1841427358
Registry record updated Jun 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
STEVE B. PARK M.D. PC
Doing business as
Cornerstone Eye Associates
Practice address
2300 Buffalo Road
BLDG 700
Rochester, NY 14624-1367
Phone
(585) 328-0153
Fax
(585) 328-0158
NPI assigned
Jun 11, 2009
Last updated
Jun 18, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2009

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

Authorized official

Name
Steve B. Park, M.D.NPI 1053393009
Title
Owner
Phone
(585) 328-0153

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X NY Primary

Addresses

Primary practice location

2300 Buffalo Road
BLDG 700
Rochester, NY 14624-1367

Mailing address

2300 Buffalo Road
BLDG 700
Rochester, NY 14624-1367
Phone (585) 328-0153

Other identifiers 7

IdentifierTypeStateIssuer
00466308MedicaidNY
11217AOtherNYMEDICARE ID-TYPE UNSPECIFIED
00468162MedicaidNY
01445376MedicaidNY
01728156MedicaidNY
02364010MedicaidNY
01093163MedicaidNY

Other names 1

  • Cornerstone Eye Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930044801 NY DME Supplier - Physician - OphthalmologyDME Supplier - OpticianDME Supplier - Physician - Optometrist 0446219372 1 other NPI on this enrollment
Practice locations: Rochester, NY

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
West Park Eye Care4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1244678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245283200000",
    "number": "1841427358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 BUFFALO ROAD",
            "address_2": "BLDG 700",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146241367",
            "telephone_number": "585-328-0153",
            "fax_number": "585-328-0158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 BUFFALO ROAD",
            "address_2": "BLDG 700",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146241367",
            "telephone_number": "585-328-0153",
            "fax_number": "585-328-0158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVE B. PARK M.D. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-11",
        "last_updated": "2009-06-18",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "STEVE",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "585-328-0153",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00466308",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID-TYPE UNSPECIFIED",
            "identifier": "11217A",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00468162",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01445376",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01728156",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02364010",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01093163",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornerstone Eye Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2009; 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.