Individual provider Active NPI

Veronica Moore-Stoll, OD

  • Optometrist
  • Bronx, NY
National Provider Identifier
1013640556
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV009540-01 Issued in NY
Practice address
3130 Grand Concourse Ste B6
Bronx, NY 10458-1265
Phone
(718) 741-3200
NPI assigned
Jul 1, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X TUV009540-01 NY Primary

Addresses

Primary practice location

3130 Grand Concourse Ste B6
Bronx, NY 10458-1265

Mailing address

536 E 82ND St Apt 1F
New York, NY 10028-7173

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
I20230925001008 NY Practitioner - Optometry 8628422789 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bronx Vista Inc.Group PAC ID 3971805151, 7 clinicians

Practice addresses (Care Compare)

455 E 149TH St
Bronx, NY 10455-1314
Phone (718) 292-2002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV009540-01NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bronx Vista Inc Optometrist CurrentSince Aug 15, 2023 Accepting new patients
Vista on 3Rd Inc. Optometrist CurrentSince Aug 15, 2023 Accepting new patients
Mark D Fromer, MD PC Multi-Specialty PastSince Jul 17, 2022 Accepting new patients

Locations

455 E 149th St
Bronx, NY 10455
Phone (718) 292-2002

2882 3rd Ave
Bronx, NY 10455
Phone (718) 585-1500

Organizations & group practices 3

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": "1656633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656633600000",
    "number": "1013640556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "536 E 82ND ST APT 1F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100287173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 GRAND CONCOURSE STE B6",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104581265",
            "telephone_number": "718-741-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE-STOLL",
        "first_name": "VERONICA",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-01",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV009540-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.