Provider Index > Optical Establishment
Provider Enrollment & Maintenance
The New York State Department of Health and the Department of Correctional Services (DOCS) have jointly implemented a program to provide eyeglass materials to Medicaid recipients whose county of fiscal responsibility is a county other than New York City. Under this program, if you become enrolled in the Medicaid Program as an eyeglass dispenser (i.e., optometrist, optician, or retail optical establishment) you would forward eyeglass prescriptions for Medicaid recipients to the DOCS/DOH Project so that the materials can be produced by DOCS at their Wallkill facility in Ulster County. The completed eyeglasses will be returned directly to you. Dispensing providers will continue to bill the Medicaid Program for their other professional services, i.e., examinations and dispensing fees. If you service recipients from counties other than New York City, youshould contact DOCS at (800) 836-2636 to receive an information package, sample frame kit and order forms.
Complete this Enrollment Form if you are: - Applying for initial ENROLLMENT or ALREADY ENROLLED and enrolling another NPI, or
- Responding to a letter instructing you to REVALIDATE your enrollment, or
- Seeking REINSTATEMENT or REACTIVATION of your previous enrollment, or
- Reporting an OWNERSHIP CHANGE
BUSINESS Enrollment Form