DR. KATHLEEN MARIE GAYNOR (OD) – Optometrist, NPI 1407803752

DR. KATHLEEN MARIE GAYNOR (OD) is a healthcare provider. based in Johnson city, New York. specializing in Optometrist. They hold the professional credentials OD. They hold a License No. TUV006927 (NY). The NPI Number for DR. KATHLEEN MARIE GAYNOR (OD) is 1407803752

Main info

Female
21 Years Of Experience
Accepts Medicare Assignment
Name
DR. KATHLEEN MARIE GAYNOR (OD)
NPI
1407803752
Phone
(607) 729-5016
Address
48 HARRISON STREET
Enumeration Date
30 May 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
STATE UNIVERSITY OF NEW YORK - STATE COLLEGE OPTOMETRY
Secondary Phone
6077542705
Graduation Year
2005 (21 years ago)
PAC ID
8921015215
Group Practice PAC ID
0749404382
Professional Enrollment ID
I20060310000614
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for DR. KATHLEEN MARIE GAYNOR (OD)

  • UHS Neurosurgery, 48, Harrison Street, Village of Johnson City, Town of Union, Broome County, New York, 13790, United States

    JOHNSON CITY, NY 13790

    Phone: (607) 729-5016

    Fax: (607) 729-7574

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2006-03-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20060310000614IOptometryNYTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 13790)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0749404382View full group profile
NameSpecialtyState
O P T O M E T R YNY
O P T O M E T R YNY
O P T O M E T R YCA
O P T O M E T R YCT
O P T O M E T R YNY

Reviews

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Frequently asked questions

What is the 10-digit NPI for DR. KATHLEEN MARIE GAYNOR (OD)?
DR. KATHLEEN MARIE GAYNOR (OD) — NPI 1407803752 — is the standard way to identify this listing.
Does the file indicate DR. KATHLEEN MARIE GAYNOR (OD) is practicing under active NPI?
Directory data currently reports DR. KATHLEEN MARIE GAYNOR (OD) as active.
What is DR. KATHLEEN MARIE GAYNOR (OD)'s primary classification?
Optometrist is the headline specialty for DR. KATHLEEN MARIE GAYNOR (OD) here. Clinical services aligned with this taxonomy classification.
What address line appears for DR. KATHLEEN MARIE GAYNOR (OD)?
DR. KATHLEEN MARIE GAYNOR (OD)'s geographic hint is Johnson City, New York in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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