Individual provider Active NPI

Edgar Ufuoma Ekure, O.D

  • Optometrist
  • Oswego, NY
National Provider Identifier
1891094488
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
007653 Issued in NY
Practice address
140B State Route 104
Oswego Plaza
Oswego, NY 13126
Phone
(315) 342-0727
NPI assigned
Mar 22, 2011
Last updated
Oct 21, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 007653 NY Primary
Optometrist 152W00000X TUV007653 NY

Addresses

Primary practice location

140B State Route 104
Oswego Plaza
Oswego, NY 13126

Mailing address

3455 Vestal Pkwy E
Vestal, NY 13850-2147
Phone (607) 722-2020

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
I20120316000442 NY Practitioner - Optometry 4587823109 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

94 Main St
Camden, NY 13316-1320
Phone (315) 245-2443

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV007653NYMDOptometrist
007653NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Poulin Eyecare Inc. Optometrist CurrentSince Jan 24, 2024 Accepting new patients
Poulin Optometric Eyecare , PLLC Optometrist CurrentSince Jan 24, 2024 Accepting new patients
Empire Vision Center, Inc CurrentSince Apr 23, 2012 Accepting new patients
Empire Vision Center Inc Optometrist CurrentSince Apr 23, 2012 Accepting new patients

Locations

2680 Delaware Ave
Ste C
Buffalo, NY 14216
Phone (716) 873-1241

94 Main St
Camden, NY 13316
Phone (315) 245-2443

560 Troy Schenectady Rd
#7
Latham, NY 12110
Phone (518) 783-0090

140 State Route 104
Ste B
Oswego, NY 13126
Phone (315) 342-0727

2921 Erie Blvd E
Syracuse, NY 13224
Phone (315) 446-3145

175 E Houston St
San Antonio, TX 78205
Phone (210) 524-6982

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1300752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1891094488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3455 VESTAL PKWY E",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138502147",
            "telephone_number": "607-722-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140B STATE ROUTE 104",
            "address_2": "OSWEGO PLAZA",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "13126",
            "telephone_number": "315-342-0727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKURE",
        "first_name": "EDGAR",
        "middle_name": "UFUOMA",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-22",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "007653",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007653",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, NY

Sources for this page

Verify at the official NPI Registry.