VERNON PERYEA,OPTOMETRIST LLC (HOPEWELL EYECARE) - NPI NUMBER 1801188776

Summary

Provider Name: VERNON PERYEA,OPTOMETRIST LLC (HOPEWELL EYECARE)

NPI Number: 1801188776

Clasification: Optometrist (152W00000X)

Address:
1123 ROUTE 82
HOPEWELL JUNCTION, NY
ZIP 12533

Phone Number: (845) 221-5310



Detailed Information

VERNON PERYEA,OPTOMETRIST LLC is an optometrist in Hopewell Junction, NY. The provider is doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. The assigned NPI number for this provider is 1801188776 and is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Hopewell Eyecare.

The provider's business address is:

1123 ROUTE 82
HOPEWELL JUNCTION, NY
ZIP 12533-206
Phone: (845) 221-5310
Fax: (845) 226-1464

The provider's authorized official is Vernon Allen Peryea .
The authorized official title is Owner and has the following contact phone number (845) 221-5310.

The enumeration date for this NPI number is 5/10/2011 and was last updated on 3/26/2014.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 152W00000X Optometrist TUV006321-1 NY Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 U98287 MEDICARE UPIN NY
2 A100060527 MEDICARE PIN NY
3 TUV0063211 OTHER NY LICENSE
4 275078419 OTHER NY TAX ID

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1801188776 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name VERNON PERYEA,OPTOMETRIST LLC The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider Other Organization Name HOPEWELL EYECARE Other name by which the organization provider is or has been known.
6 Provider Other Organization Name Type Code 5 Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
7 Provider First Line Business Practice Location Address 1123 ROUTE 82 The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
8 Provider Business Practice Location Address City Name HOPEWELL JUNCTION The city name in the location address of the provider being identified.
9 Provider Business Practice Location Address State Name NY The State code in the location of the provider being identified.
10 Provider Business Practice Location Address Postal Code 125336206 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
11 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
12 Provider Business Practice Location Address Telephone Number 8452215310 The telephone number associated with the location address of the provider being identified.
13 Provider Business Practice Location Address Fax Number 8452261464 The fax number associated with the location address of the provider being identified.
14 Provider Enumeration Date 5/10/2011 The date the provider was assigned a unique identifier (assigned an NPI).
15 Last Update Date 3/26/2014 The date that a record was last updated or changed.
16 Authorized Official Last Name PERYEA The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
17 Authorized Official First Name VERNON The first name of the authorized official.
18 Authorized Official Middle Name ALLEN The middle name of the authorized official.
19 Authorized Official Title or Position OWNER The title or position of the authorized official.
20 Authorized Official Telephone Number 8452215310 The 10-position telephone number of the authorized official.
21 Healthcare Provider Taxonomy Code 1 152W00000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
22 Provider License Number 1 TUV006321-1 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
23 Provider License Number State Code 1 NY The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
24 Healthcare Provider Primary Taxonomy Switch 1 Y
25 Other Provider Identifier 1 U98287 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
26 Other Provider Identifier Type Code 1 02 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
27 Other Provider Identifier State 1 NY
28 Other Provider Identifier 2 A100060527 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
29 Other Provider Identifier Type Code 2 08 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
30 Other Provider Identifier State 2 NY
31 Other Provider Identifier 3 TUV0063211 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
32 Other Provider Identifier Type Code 3 01 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
33 Other Provider Identifier State 3 NY
34 Other Provider Identifier Issuer 3 LICENSE
35 Other Provider Identifier 4 275078419 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
36 Other Provider Identifier Type Code 4 01 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
37 Other Provider Identifier State 4 NY
38 Other Provider Identifier Issuer 4 TAX ID
39 Is Organization Subpart N
40 Authorized Official Name Prefix Text DR.
41 Authorized Official Name Suffix Text JR.
42 Authorized Official Credential Text O.D.
43 Healthcare Provider Taxonomy Group 1 193400000X SINGLE SPECIALTY GROUP

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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