Active NPI
Svetlana Katanov, OD
- Optometrist
- Forest Hills, NY
National Provider Identifier
1003963992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- VUT 6255-1
- Practice address
- 10423 Oueens Blvd
Forest Hills, NY 11375 - Phone
- (718) 275-2500
- NPI assigned
- Jan 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | VUT 6255-1 | NY | Primary |
Addresses
Primary practice location
10423 Oueens Blvd
Forest Hills, NY 11375
Mailing address
6524 Ellwell Cres
Rego Park, NY 11374-5032
Phone (718) 459-7973
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02645590 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| VUT 6255-1 | NY | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East West Opticians | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Optician
- Glen Oaks, NY
- NPI 1750472684
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003963992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6524 ELLWELL CRES",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113745032",
"telephone_number": "718-459-7973"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10423 OUEENS BLVD",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "11375",
"telephone_number": "718-275-2500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KATANOV",
"first_name": "SVETLANA",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "VUT 6255-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02645590",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.