NPIMap

Organization Active NPI

Vision Quest of Bruckner Corp.

  • Eyewear Supplier
  • Bronx, NY
National Provider Identifier
1003968819
Registry record updated Sep 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
4061 Issued in NY
Legal business name
VISION QUEST OF BRUCKNER CORP.
Practice address
905 White Plains Rd
Bronx, NY 10473-2522
Phone
(718) 239-9389
NPI assigned
Jan 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sheri Smith
Title
Manager
Phone
(718) 626-5184

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 4061 NY
Eyewear Supplier 332H00000X 4061 NY Primary

Addresses

Primary practice location

905 White Plains Rd
Bronx, NY 10473-2522

Mailing address

3073 Steinway St
Astoria, NY 11103-3801
Phone (718) 626-5184

Other names 1

  • Vision Quest Bronx Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170301000153 NY Part B Supplier - Clinic/Group Practice 6002190592 Receives reassigned benefits from 5 practitioners
Practice locations: Bronx, NY

National Provider Directory

National Provider Directory

Locations

905 White Plains Rd
Bronx, NY 10473
Phone (718) 239-9389

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474416000000",
    "number": "1003968819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3073 STEINWAY ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111033801",
            "telephone_number": "718-626-5184",
            "fax_number": "718-626-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 WHITE PLAINS RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104732522",
            "telephone_number": "718-239-9389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION QUEST OF BRUCKNER CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2016-09-21",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SHERI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "718-626-5184"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "4061",
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NY",
            "license": "4061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vision Quest Bronx",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; 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.

Verify at the official NPI Registry.