MEDICARE: MR. DONALD BRUCE KNAPP O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	VUT003992-1	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
12	P017002202	OTHER	NY	MEDICARE BLUE PPO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0005109317	OTHER	NY	AETNA
2	P010003992	OTHER	NY	BLUEPOINT 2
3	P017002202	OTHER	NY	HMO BLUE OPTION
4	16-1182665	OTHER	NY	TRICARE
5	P010003992	OTHER	NY	EXCELLUS HEALTH PLAN
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	16-1182665	OTHER	NY	UNITED HEALTHCARE INSURAN
8	161182665001	OTHER	TX	TODAY'S OPTIONS
9	161182665001	OTHER	TX	AMERICAN PROGRESSIVE
10	595113	OTHER	NY	MVP HEALTH PLAN, INC
11	16-1182665-002	OTHER	NY	RMSCO, INC
13	16-1182665	OTHER	NY	EMPIRE PLAN
14	200055337	OTHER	NY	MVP HEALTH PLAN, INC
15	N 1790859965	OTHER	NY	FIRST AMERICAN LIFE INSUR

General Provider Information

NPI Number	:	1184614109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DONALD BRUCE KNAPP O.D.

Provider Business Mailing Address
First Line	:	2549 SULPHUR SPRINGS RD
Second Line	:
City	:	SAUQUOIT
State	:	NY
Zip	:	13456-3217
Country	:	US
Telephone Number	:	315-794-8657
Fax Number	:

Provider Business Practice Location Address
First Line	:	392 W MAIN ST
Second Line	:
City	:	WEST WINFIELD
State	:	NY
Zip	:	13491-2903
Country	:	US
Telephone Number	:	315-822-5678
Fax Number	:	315-822-5973

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	02/18/2020

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