Individual provider Active NPI

Peter J Vishton, O.D.

  • Optometrist
  • Cuba, NY
National Provider Identifier
1952393779
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV0035251 Issued in NY
Practice address
26 Genesee St
Cuba, NY 14727-1115
Phone
(585) 968-2210
Fax
(856) 627-2020
NPI assigned
Aug 17, 2005
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003525NYMDBehavioral Analyst
TUV0035251NYMDOptometrist

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV0035251 NY Primary

Addresses

NPPES NPI Registry

Primary practice location

26 Genesee St
Cuba, NY 14727-1115

Mailing address

2 Duck Pond CT
Voorhees, NJ 08043-3686
Phone (856) 627-2020

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
0433900001OtherNYNSC

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952393779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 DUCK POND CT",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080433686",
            "telephone_number": "856-627-2020",
            "fax_number": "856-627-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 GENESEE ST",
            "city": "CUBA",
            "state": "NY",
            "postal_code": "147271115",
            "telephone_number": "585-968-2210",
            "fax_number": "856-627-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISHTON",
        "first_name": "PETER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV0035251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NSC",
            "identifier": "0433900001",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cuba, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.