Provider Demographics
NPI:1134391725
Name:VISION CARE CENTER
Entity type:Organization
Organization Name:VISION CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:BARTELS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:716-693-4606
Mailing Address - Street 1:501 KAYMAR DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-3466
Mailing Address - Country:US
Mailing Address - Phone:716-693-4606
Mailing Address - Fax:716-693-7329
Practice Address - Street 1:2126 NIAGARA FALLS BLVD
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150-4700
Practice Address - Country:US
Practice Address - Phone:716-693-4606
Practice Address - Fax:716-693-7329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-24
Last Update Date:2018-12-19
Deactivation Date:2008-07-11
Deactivation Code:
Reactivation Date:2018-12-19
Provider Licenses
StateLicense IDTaxonomies
NYTUV004096-1332B00000X, 332H00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
No332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00030024001OtherBLUE CROSS AND BLUE SHIEL
NY10227701OtherBUFFALO COMMUNITY HEALTH
NY5748343OtherAETNA
NY004141OtherMEDICARE PROVIDER ID
NY00010227701OtherUNIVERA HEALTHCARE
NY7209531OtherINDEPENDENT HEALTH
NYNY4096OtherEYEMED
NYNY04096OtherVISION BENEFITS OF AMERIC