Brockport Optometry, PC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

BROCKPORT OPTOMETRY, PC

Practice address

22 N Main St
Lower Suite
Brockport, NY 14420-1614

Phone

(585) 637-2121

Fax

(585) 637-7722

NPI assigned

May 13, 2007

Last updated

Jul 30, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael Lee Raff, ODNPI 1609831080

Title

President

Phone

(585) 637-2121

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

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.

• Michael Lee Raff, OD

  • Corneal and Contact Management Optometrist
  • Brockport, NY
  • NPI 1609831080
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1179014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217376000000",
    "number": "1912112889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 FARM FIELD LN",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "145342865",
            "telephone_number": "585-248-2141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 N MAIN ST",
            "address_2": "LOWER SUITE",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144201614",
            "telephone_number": "585-637-2121",
            "fax_number": "585-637-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROCKPORT OPTOMETRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-13",
        "last_updated": "2008-07-30",
        "status": "A",
        "authorized_official_last_name": "RAFF",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "585-637-2121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brockport Dental PLLC
• Brockport Internal Medicine, PC
• Brockport Marriage & Family Therapy, P.C.
• Brockport Medical Care PLLC (Brockport ASAP Medical Care)
• Brockport Optometry, PC
• Brockport Vine Medical PC
• Brockport Volunteer Ambulance Corps Inc
• Terri Buchinski, LICSW
• Nadezhda Bulbotko, RN
• Brianna Lynn Bunch, LPN

• Optometrist in Brockport, NY
• Providers in Brockport, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; 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.