DR. JOHN S ETTENSON (NPI# 1396714820) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396714820 |
| Entity Type | Individual |
| Full Name | DR. JOHN S ETTENSON |
| Credential | MD |
| Practice Address |
1 Theall Rd Rye NY 10580-1404 |
| Mailing Address |
210 Westchester Ave White Plains NY 10604-2901 |
| Practice Telephone | 9148488800 |
| Practice Fax Number | 9146826403 |
| Mailing Telephone | 9146813146 |
| Mailing Fax Number | 9146826403 |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2013-10-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | 041999 | CT | Allopathic & Osteopathic Physicians |
| Y | 207W00000X | Ophthalmology | 174308-1 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | EMPIRE BCBS | 21E601 | 01 |
| NY | CIGNA | 133757245 | 01 |
| NY | 01072893 | 05 |
| Street Address |
1 THEALL RD |
| City | RYE |
| State | NY |
| Zip Code | 10580-1404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477551851 | Walter E Bottizer | Radiology | 1 Theall Rd, Rye, NY 10580-1404 | 2005-07-11 |
| 1245879816 | Deborah Ann Delluomo | Social Worker | 1 Theall Rd, Rye, NY 10580-1404 | 2019-12-31 |
| 1780039040 | Shinette Serna - Bantug | Physical Therapist | 1 Theall Rd, Rye, NY 10580-1404 | 2016-04-24 |
| 1841653086 | Lisa J Luehman | Nurse Practitioner | 1 Theall Rd, Rye, NY 10580-1404 | 2016-04-04 |
| 1366804486 | Colleen Purcell Tenan | Internal Medicine | 1 Theall Rd, Rye, NY 10580-1404 | 2016-03-28 |
| 1134518145 | Ian Yarett | Internal Medicine | 1 Theall Rd, Rye, NY 10580-1404 | 2015-01-14 |
| 1831590645 | Christina Maureen Schubert | Physician Assistant | 1 Theall Rd, Rye, NY 10580-1404 | 2014-09-11 |
| 1831536291 | Ashley Monroe Pritchard | Obstetrics & Gynecology | 1 Theall Rd, Rye, NY 10580-1404 | 2013-05-25 |
| 1477829018 | Alicia Isabel Robbins | Obstetrics & Gynecology | 1 Theall Rd, Rye, NY 10580-1404 | 2012-03-28 |
| 1407177553 | Lisa Pham Anthony | Dermatology | 1 Theall Rd, Rye, NY 10580-1404 | 2010-06-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720624984 | Kathleen Brennan | Occupational Therapist | The Osborn, 101 Theall Rd., Rye, NY 10580 | 2019-11-22 |
| 1760991046 | Dorothy Reisner | Counselor | 40 Midland Ave, Rye, NY 10580 | 2017-09-29 |
| 1295113280 | Purchase Street Family Dental P.C. | Dentist | 266 Purchase St., Rye, NY 10580 | 2015-05-11 |
| 1245617588 | Lauren Rosen | Social Worker | 16 School Street, Lower Level Suites, Rye, NY 10580 | 2015-05-06 |
| 1487057683 | Advances In Contemporary Psychology LLC | Psychologist | 66 Milton Road, #a12, Rye, NY 10580 | 2014-10-01 |
| 1508277583 | Ruth Ursula Donovan | Pediatrics | 2104 Theall Road, Rye, NY 10580 | 2014-05-13 |
| 1407267610 | Lori Watkins Cohen | Dentist | 105-107 Theodore Fremd Ave, Rye, NY 10580 | 2014-05-12 |
| 1134541865 | Paul K. Chu, Dds, Pllc | Dentist | 130 Thedore Fremd #m2, Rye, NY 10580 | 2014-01-15 |
| 1760812705 | Steven Edward Norman | Specialist/Technologist | 1 Cedar Street, Rye, NY 10580 | 2013-11-12 |
| 1689921181 | Teresa Caridi | Health Educator | 18 Summit Avenue, Rye, NY 10580 | 2012-08-14 |
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| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578887048 | Ralph Sloan Wilson Sr. | Ophthalmology | 140 Washington Rd., Rye, NH 03870 | 2010-03-26 |
| 1780856690 | Robert Latkany Md PC | Ophthalmology | 35 Coolidge Ave, Rye, NY 10580-1306 | 2008-03-31 |
| 1780604678 | Paul Robert Kalkut | Ophthalmology | 14 Hook Rd, Rye, NY 10580-3716 | 2006-07-20 |
| 1427078310 | Howard Charles | Ophthalmology | 101 S Bedford Rd Ste 404, Care Mount Medical PC, Rye, NY 10580-2141 | 2006-07-20 |
| 1699971101 | Westchester Vitreo Retinal, PC | Ophthalmology | 150 Purchase St, Suite 6, Rye, NY 10580-2141 | 2007-06-22 |
| 1538153705 | Steven Carl Greenberg | Ophthalmology | 1 Theall Rd, Rye, NY 10580-1404 | 2005-09-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821607995 | Reginald Camillo Md Pllc | Ophthalmology | 7708 Broadway, Elmhurst, NY 11373-1927 | 2020-07-24 |
| 1366069510 | Rebecca Stein | Ophthalmology | 711 Stewart Ave Ste 160, Garden City, NY 11530-4700 | 2020-07-02 |
| 1548886260 | Bartow Ophthalmology Pllc | Ophthalmology | 2100 Bartow Ave Ste 208, Bronx, NY 10475-4614 | 2020-06-18 |
| 1407485139 | Amy L Kreisberg | Ophthalmology | 25 Byron Ln, Larchmont, NY 10538-1617 | 2020-04-04 |
| 1922634518 | Vision Vibrant Medicine Pllc | Ophthalmology | 837 59th St, Brooklyn, NY 11220-3611 | 2020-03-16 |
| 1710546270 | Ian Chan Md PC | Ophthalmology | 6410 8th Ave # 2a, Brooklyn, NY 11220-4720 | 2019-06-09 |
| 1598320038 | Mid-hudson Family Ophthalmology, Pllc | Ophthalmology | 75 Crystal Run Rd Ste 104a, Middletown, NY 10941-7003 | 2019-05-09 |
| 1144885070 | Nan Alison Sutter Hayworth | Ophthalmology | 214 Mclain St, Mount Kisco, NY 10549-4931 | 2019-05-06 |
| 1104383660 | Shani Golan | Ophthalmology | 325 E 64th St, New York, NY 10065-6709 | 2019-02-20 |
| 1205391224 | Gautam Kamthan Md PC | Ophthalmology | 250 E 39th St Apt 11g, New York, NY 10016-2178 | 2019-02-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.