NPIMap

Organization Active NPI

Eye Surgeons of Central New York, PC

Doing business as Eye Physicians of Central New York

  • Ophthalmology Physician
  • Liverpool, NY
National Provider Identifier
1881725810
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
154663-1 Issued in NY
Legal business name
EYE SURGEONS OF CENTRAL NEW YORK, PC
Doing business as
Eye Physicians of Central New York
Practice address
5100 W Taft Rd Ste 4M
Liverpool, NY 13088-3810
Phone
(315) 362-3937
Fax
(315) 458-7818
NPI assigned
Mar 9, 2007
Last updated
Oct 26, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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

Authorized official

Name
Mr. Chip J. Vanallen
Title
Financial Manager
Phone
(315) 382-4284

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV005797-1 NY
Optometrist 152W00000X NU
Ophthalmology Physician 207W00000X 154663-1 NY Primary

Addresses

Primary practice location

5100 W Taft Rd Ste 4M
Liverpool, NY 13088-3810

Mailing address

5100 W. Taft Road, Suite 4M
Liverpool, NY 13088
Phone (315) 362-3937

Other practice location 1

6839 Highway 6 N
Houston, TX 77084-1315
Phone (281) 859-9136

Other names 1

  • Eye Physicians of Central New York Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110620000237 NY Part B Supplier - Clinic/Group Practice 7416135504 Receives reassigned benefits from 6 practitioners
Practice locations: Liverpool, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635206400000",
    "number": "1881725810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 W. TAFT ROAD, SUITE 4M",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "13088",
            "telephone_number": "315-362-3937",
            "fax_number": "315-458-7818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W TAFT RD STE 4M",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883810",
            "telephone_number": "315-362-3937",
            "fax_number": "315-458-7818"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6839 Highway 6 N",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770841315",
            "country_code": "US",
            "telephone_number": "281-859-9136",
            "fax_number": "281-550-2814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EYE SURGEONS OF CENTRAL NEW YORK, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A",
        "authorized_official_last_name": "VANALLEN",
        "authorized_official_first_name": "CHIP",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "FINANCIAL MANAGER",
        "authorized_official_telephone_number": "315-382-4284",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV005797-1",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "154663-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Physicians of Central New York",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eye Physicians of Central New York",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Liverpool, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; 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.