NPIMap

Organization Active NPI

Costello Sr. - Allen Optometrists PLLC

  • Optometrist
  • Oneida, NY
National Provider Identifier
1982755948
Registry record updated Sep 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV002717 Issued in NY
Legal business name
COSTELLO SR. - ALLEN OPTOMETRISTS PLLC
Practice address
578 Seneca St
Oneida, NY 13421-2600
Phone
(315) 363-4942
Fax
(315) 363-4441
NPI assigned
Jan 16, 2007
Last updated
Sep 17, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2013

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

Authorized official

Name
Dr. Matthew C. Allen, O.D.NPI 1841369436
Title
Owner
Phone
(315) 363-4942

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV002717 NY Primary
Optometrist 152W00000X TUV006206 NY
Optometrist 152W00000X TUV007184 NY
Optometrist 152W00000X TUV006131 NY

Addresses

Primary practice location

578 Seneca St
Oneida, NY 13421-2600

Mailing address

578 Seneca St
Oneida, NY 13421-2600
Phone (315) 363-4942

Other identifiers 3

IdentifierTypeStateIssuer
02302867MedicaidNY
02961255MedicaidNY
410039620OtherNYRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

578 Seneca St
Oneida, NY 13421
Phone (315) 361-4300

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379376000000",
    "number": "1982755948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "578 SENECA ST",
            "city": "ONEIDA",
            "state": "NY",
            "postal_code": "134212600",
            "telephone_number": "315-363-4942",
            "fax_number": "315-363-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "578 SENECA ST",
            "city": "ONEIDA",
            "state": "NY",
            "postal_code": "134212600",
            "telephone_number": "315-363-4942",
            "fax_number": "315-363-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSTELLO SR. - ALLEN OPTOMETRISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2013-09-17",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-363-4942",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV002717",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006206",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007184",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006131",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02302867",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02961255",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410039620",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oneida, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; 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.