Individual provider Active NPI

Marycarol Graby, O.D.

  • Optometrist
  • Rochester, NY
National Provider Identifier
1972944668
Registry record updated Jul 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV008203 Issued in NY
Practice address
2301 Lac Deville Blvd
Rochester, NY 14618-5646
Phone
(585) 244-0332
NPI assigned
Jul 10, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV008203 NY Primary

Addresses

Primary practice location

2301 Lac Deville Blvd
Rochester, NY 14618-5646

Mailing address

2301 Lac Deville Blvd
Rochester, NY 14618-5646
Phone (585) 244-0332

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
I20140902000130 NY Practitioner - Optometry 4880812098 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV008203NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester Eye Associates Physicians and Surgeons PC CurrentSince Sep 1, 2014 Accepting new patients
Western New York Medical Practice, P.C. CurrentSince May 1, 2022 Accepting new patients
Western New York Medical Practice P.C. Past Accepting new patients

Locations

10 S Pointe Lndg
Ste 230
Rochester, NY 14606
Phone (585) 244-0332

2301 Lac de Ville Blvd
Rochester, NY 14618
Phone (585) 244-0332

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": "1373414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404259200000",
    "number": "1972944668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 LAC DEVILLE BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146185646",
            "telephone_number": "585-244-0332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 LAC DEVILLE BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146185646",
            "telephone_number": "585-244-0332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRABY",
        "first_name": "MARYCAROL",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-10",
        "last_updated": "2014-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV008203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.