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NPI 1720481138ActiveIndividual· Optometrist· Woodside, NY

Optometrist in Woodside, New York, trained at Pennsylvania College of Optometry (class of 2014). Medicare paid $2,946 for services to 11 patients in 2024.

Overview

NPI1720481138
StatusActive
Entity typeIndividual
Sole proprietorYes
NPI issuedSep 29, 2014
Last updated in NPPESSep 29, 2014

Specialties and licenses

TaxonomyCodeLicenseState
Optometrist Primary152W00000X008227NY

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026No match—
New York OMIG · Nov 10, 2026No match—
Ohio Medicaid · Nov 10, 2026No match—
Pennsylvania Medicheck · Nov 10, 2026No match—
Washington HCA · Nov 10, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Enrolled Practitioner - Optometry (NY)
Accepts assignmentYes (participating)

Medicare services in 2024

Medicare patients11
Services billed65 across 9 procedure codes
Paid by Medicare$2,946

Medicare sources and data years

Education and affiliations

Medical schoolPennsylvania College of Optometry
Graduation year2014
Medicare specialtyOptometry

Source: CMS Care Compare

Industry payments (Open Payments)

None reported for 2025 or 2024.

Receiving payments does not imply wrongdoing. What Open Payments covers ·original records

Other Optometrist providers in Woodside

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