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DR. SONIA HERNANDEZ CARUSO DO
NPI 1902188873
Ophthalmology in Johnstown, NY

Active since September 15, 2011PECOS Enrolled
229 HALES MILLS RD, JOHNSTOWN, NY 12095(214) 471-3597 Get Directions Write a Review

NPPES record last updated: August 17, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 17, 2021, Aug 3, 2021 (2 updates tracked since 2021).

About Dr. Sonia Hernandez Caruso Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SONIA HERNANDEZ CARUSO DO (NPI 1902188873) is an individual ophthalmology provider in Johnstown, New York, licensed in New York (251522) and active in the NPI registry since September 2011. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1902188873
Entity TypeIndividualFemale
Primary Taxonomy207W00000X
Provider Legal NameDR. SONIA HERNANDEZ CARUSOCredential: DO
Location Address229 HALES MILLS RDJohnstown, NY 12095-3743
Mailing Address229 Hales Mills RdJohnstown, NY 12095-3743 · (214) 471-3597
Phone(214) 471-3597
Sole ProprietorNo
Enumeration DateSeptember 15, 2011
Last NPPES UpdateAugust 17, 20212 updates tracked since enumeration
NPPES CertifiedAugust 17, 2021
✔ NPI 1902188873 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
Licenses✔ Licensed in NY · 251522✔ Licensed in NM · A-1699-12
Definition
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.
Also ListedGeneral PracticeTaxonomy 208D00000X · License 251522 (NY), A-1699-12 (NM)
229 HALES MILLS RD, Johnstown, NY 12095
Open in Google Maps ↗

Other Names 1

Former Name (1)Dr. Sonia Hernandez Do

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Sonia Hernandez Caruso Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Sonia Hernandez Caruso reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Kwiat Eye And Laser Surgery PLLC
7.5 mi
Ophthalmology
100 HOLLAND CIRCLE DR
Amsterdam, NY 12010
  • Reassigned Medicare billing, New York enrollment
  • 19 clinicians in this Medicare group
NPI 1275763468 (518) 842-3800
Brookview Medical Associates, PLLC
167 mi
General Practice
80 ORVILLE DR STE 100
Bohemia, NY 11716
  • Reassigned Medicare billing, New York enrollment
  • 754 clinicians in this Medicare group
NPI 1871965855 (972) 715-3800

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 12095 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.40 typical visit price
range $54.87 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$68.57 typical visit price
range $17.54 – $136.14
Typical copayment $17.14 (range $4.38 – $34.03)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
94%53 patients4/55-star benchmark: 100%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
100%46 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CARUSO EYE AND RETINA CONSULTANTS L.L.C.
Ophthalmology
229 HALES MILLS RD
JOHNSTOWN, NY 12095
Fulton County (214) 471-3597

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sonia Hernandez Caruso's NPI number?

The NPI number for Sonia Hernandez Caruso is 1902188873. It was assigned to this individual provider in the NPPES registry on September 15, 2011. The provider is also known as Dr. Sonia Hernandez Do.

Where is Sonia Hernandez Caruso located?

Sonia Hernandez Caruso practices at 229 Hales Mills Rd, Johnstown, NY 12095. The listed phone number is (214) 471-3597.

What is Sonia Hernandez Caruso's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Sonia Hernandez Caruso enrolled in Medicare?

Yes. Sonia Hernandez Caruso is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Sonia Hernandez Caruso's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sonia Hernandez Caruso reassigns Medicare benefits to 2 organizations: Kwiat Eye And Laser Surgery PLLC (Amsterdam, NY) and Brookview Medical Associates, PLLC (Bohemia, NY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Sonia Hernandez Caruso's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Sonia Hernandez Caruso was last updated on August 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.