Active NPI
Vivid Vision Optometry PLLC
- Optometrist
- Mount Vernon, NY
National Provider Identifier
1003368192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 007773
- Legal business name
- VIVID VISION OPTOMETRY PLLC
- Practice address
- 500 E Sandford Blvd
Mount Vernon, NY 10550-4750 - Phone
- (914) 297-4337
- NPI assigned
- Oct 25, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Isadora Ritter, OD
- Title
- Doctor of Optometry
- Phone
- (646) 942-8022
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 007773 | NY | Primary |
Addresses
Primary practice location
500 E Sandford Blvd
Mount Vernon, NY 10550-4750
Mailing address
225 E 95TH St
16E
New York, NY 10128-4000
Phone (646) 942-8022
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03382712 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
National Provider Directory
National Provider Directory- Tax ID family
- Vivid Vision Optometry PLLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Optometrist
- Bronx, NY
- NPI 1427604610
Locations
4377 Bronx Blvd
Rm 3
Bronx, NY 10466
Phone (646) 942-8022
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- New York, NY
- NPI 1548552110
-
- Optometrist
- Yonkers, NY
- NPI 1902172513
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477353600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1565827200000",
"number": "1003368192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 E 95TH ST",
"address_2": "16E",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101284000",
"telephone_number": "646-942-8022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 E SANDFORD BLVD",
"city": "MOUNT VERNON",
"state": "NY",
"postal_code": "105504750",
"telephone_number": "914-297-4337"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VIVID VISION OPTOMETRY PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2016-10-25",
"last_updated": "2019-08-15",
"status": "A",
"authorized_official_last_name": "RITTER",
"authorized_official_first_name": "ISADORA",
"authorized_official_title_or_position": "DOCTOR OF OPTOMETRY",
"authorized_official_telephone_number": "646-942-8022",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "NY",
"license": "007773",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03382712",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mount Vernon, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.