Individual provider Active NPI

Samantha Slotnick, OD, FAAO, FCOVD

  • Vision Therapy Optometrist
  • Scarsdale, NY
National Provider Identifier
1902017965
Registry record updated Aug 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vision Therapy OptometristTaxonomy code 152WV0400X
License
TUV006820 Issued in NY
Practice address
495 Central Park Ave Ste 301
Scarsdale, NY 10583-1038
Phone
(914) 874-1118
Fax
(914) 885-1463
NPI assigned
May 24, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OA00597800 NJ
Pediatric Optometrist 152WP0200X TUV006820 NY
Vision Therapy Optometrist 152WV0400X TUV006820 NY Primary

Addresses

Primary practice location

495 Central Park Ave Ste 301
Scarsdale, NY 10583-1038

Mailing address

23 Old Mamaroneck Rd Apt 4L
White Plains, NY 10605-2013
Phone (914) 874-1118

Other identifiers 1

IdentifierTypeStateIssuer
A300083922OtherMEDICARE PTAN- PROVIDER TRANSACTION ACCESS NUMBER

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
I20050326000004 NY Practitioner - Optometry 6103872767 Reassigns benefits to 1 organization
Practice locations: Scarsdale, NY

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

495 Central Park Ave
Suite 301
Scarsdale, NY 10583-1038
Phone (914) 874-1177

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OA00597800NJMDOptometrist
TUV006820NYMDVision Therapy Optometrist
006820NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Samantha Slotnick, Inc Optometrist CurrentSince May 13, 2015 Accepting new patients
Terri Optics, Inc. PastSince Jul 21, 1993 Accepting new patients
Terri Optics Optometrist Past Accepting new patients

Locations

495 Central Park Ave
Ste 301
Scarsdale, NY 10583
Phone (914) 472-7211

Organizations & group practices 3

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": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439078400000",
    "number": "1902017965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 OLD MAMARONECK RD APT 4L",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106052013",
            "telephone_number": "914-874-1118",
            "fax_number": "914-885-1463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 CENTRAL PARK AVE STE 301",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105831038",
            "telephone_number": "914-874-1118",
            "fax_number": "914-885-1463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOTNICK",
        "first_name": "SAMANTHA",
        "name_prefix": "Dr.",
        "credential": "OD, FAAO, FCOVD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2015-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00597800",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "NY",
            "license": "TUV006820",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "NY",
            "license": "TUV006820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN- PROVIDER TRANSACTION ACCESS NUMBER",
            "identifier": "A300083922",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarsdale, NY

Sources for this page

Verify at the official NPI Registry.