Individual provider Active NPI

Nadezhda Kalantarova, O.D.

  • Optometrist
  • Flushing, NY
National Provider Identifier
1013466275
Registry record updated Sep 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV008522-1 Issued in NY
Practice address
14754 76TH Rd
Mailbox 2 , 2ND Floor
Flushing, NY 11367-3140
Phone
(917) 744-9790
NPI assigned
Sep 29, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV008522-1 NY Primary

Addresses

Primary practice location

14754 76TH Rd
Mailbox 2 , 2ND Floor
Flushing, NY 11367-3140

Mailing address

14754 76TH Rd
Mailbox 2 , 2ND Floor
Flushing, NY 11367-3140
Phone (917) 744-9790

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
I20180111002207 NY Practitioner - Optometry 5294094561 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV008522-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
National Vision Care Center Inc. CurrentSince Nov 6, 2017 Accepting new patients
National Vision Care Center Inc Optometrist PastSince Nov 6, 2017 Accepting new patients

Locations

10219 Roosevelt Ave
Corona, NY 11368
Phone (718) 290-3566

Organizations & group practices 2

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": "1475107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475107200000",
    "number": "1013466275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14754 76TH RD",
            "address_2": "MAILBOX 2 , 2ND FLOOR",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113673140",
            "telephone_number": "917-744-9790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14754 76TH RD",
            "address_2": "MAILBOX 2 , 2ND FLOOR",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113673140",
            "telephone_number": "917-744-9790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALANTAROVA",
        "first_name": "NADEZHDA",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-29",
        "last_updated": "2016-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV008522-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.