Dale Paynter
Individual provider Active NPI Optometrist · De Witt, NY
NPI 1952703530 · NPPES record last updated Sep 25, 2014
Key facts
- NPI
- 1952703530
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 008230 (NY)
- Practice address
- 3401 Erie Blvd E
De Witt, NY 13214-1635 - Phone
- (315) 446-4446
- NPI assigned
- Sep 25, 2014
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150909001399 | NY | Practitioner - Optometry | 0345557237 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008230 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Empire Vision Center Inc | Optometrist | Current |
Accepting new patients |
| Empire Vision Center, Inc | Current |
Accepting new patients | |
| Empire Vision Center Inc | Optometrist | Past | Accepting new patients |
| America'S Best Contacts & Eyeglasses | Past | Accepting new patients |
Locations
2680 Delaware Ave
Ste C
Buffalo, NY 14216
Phone (716) 873-1241
6859 E Genesee St
Fayetteville, NY 13066
Phone (315) 251-2206
560 Troy Schenectady Rd
#7
Latham, NY 12110
Phone (518) 783-0090
1930 South Rd
#105
Poughkeepsie, NY 12601
Phone (845) 298-3200
2590 W Ridge Rd
Rochester, NY 14626
Phone (585) 227-7150
2921 Erie Blvd E
Syracuse, NY 13224
Phone (315) 446-3145
4109 W Genesee St
Syracuse, NY 13219
Phone (315) 488-2020
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 008230 | NY | Yes |
Addresses
Primary practice location
3401 Erie Blvd E
De Witt, NY 13214-1635
Mailing address
5 Gray Fox LN
Albany, NY 12203-5332
Other providers in De Witt, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 25, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.