Crystal Clear Vision Corp.

Primary specialty

OptometristTaxonomy code 152W00000X

License

002805 Issued in NY

Legal business name

CRYSTAL CLEAR VISION CORP.

Practice address

88 Dunning Rd Ste 16
Middletown, NY 10940-2218

Phone

(845) 692-5800

Fax

(845) 692-5880

NPI assigned

Nov 20, 2006

Organization subpart

No

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

Authorized official

Name

Michelle Ericksen

Title

Assistant

Phone

(845) 692-5800

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Adonya Blair, O.D.

  • Optometrist
  • New York, NY
  • NPI 1508979170
  Medicare reassignment NPD

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740009600000",
    "number": "1932273026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 DUNNING RD STE 16",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402218",
            "telephone_number": "845-692-5800",
            "fax_number": "845-692-5880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 DUNNING RD STE 16",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402218",
            "telephone_number": "845-692-5800",
            "fax_number": "845-692-5880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL CLEAR VISION CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A",
        "authorized_official_last_name": "ERICKSEN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "ASSISTANT",
        "authorized_official_telephone_number": "845-692-5800"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "002805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02706105",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daisy Ann Cruz
• Laura K Cruz, DC
• Michelle Cruz, LP
• Natalie Ann Cruz
• Pavel Cruz, FNP-BC
• Crystal Run Ambulatory Surgery Center of Middletown, LLC
• Crystal Run Healthcare LLP
• Crystal Run Healthcare Physicians LLP
• Crystal Run Healthcare Physicians LLP
• Crystal Run Healthcare Physicians LLP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.