Individual provider Active NPI

Leslie R. Kolker, O.D.

  • Optometrist
  • New Hyde Park, NY
National Provider Identifier
1003992603
Registry record updated Jan 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T 004430 Issued in NY
Practice address
2001 Marcus Ave
Suite 286 West
New Hyde Park, NY 11042-1011
Phone
(516) 328-1800
Fax
(516) 358-2329
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T 004430 NY Primary

Addresses

Primary practice location

2001 Marcus Ave
Suite 286 West
New Hyde Park, NY 11042-1011

Mailing address

2001 Marcus Ave
Suite 286 West
New Hyde Park, NY 11042-1011
Phone (516) 328-1800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040921000431 NY Practitioner - Optometry 8527036227 Practice locations: Roslyn, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004430NYMDBehavioral Analyst
T 004430NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Leslie R Kolker OD Optometrist CurrentSince Dec 20, 1999 Accepting new patients
DRS. Farkas, Kassalow, Resnick & Associates Optometrist Past Accepting new patients
DRS. Farkas, Kassalow, Resnick & Associates, PC Optometrist Past Accepting new patients
Harbor Optics Inc Optometrist PastSince Sep 1, 2014 Accepting new patients

Locations

1000 Northern Blvd
Ste 310
Great Neck, NY 11021
Phone (516) 328-1800

2001 Marcus Ave
Ste W286
New Hyde Park, NY 11042
Phone (516) 328-1800

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3699/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199318400000",
    "number": "1003992603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 MARCUS AVE",
            "address_2": "SUITE 286 WEST",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421011",
            "telephone_number": "516-328-1800",
            "fax_number": "516-358-2329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 MARCUS AVE",
            "address_2": "SUITE 286 WEST",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421011",
            "telephone_number": "516-328-1800",
            "fax_number": "516-358-2329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLKER",
        "first_name": "LESLIE",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2008-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "T 004430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.