Shore Vision LTD

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

007789 Issued in NY

Legal business name

SHORE VISION LTD

Practice address

4644 Merrick Rd
Massapequa, NY 11758-6030

Phone

(516) 860-6659

NPI assigned

Mar 4, 2018

Last updated

Nov 16, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Elizabeth Burton

Title

Optician/Owner

Phone

(516) 860-6659

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alice Hart, O.D.

  • Optometrist
  • Melville, NY
  • NPI 1760812143
  Medicare reassignment Care Compare group NPD
• Theresa Maria Rua, O.D.

  • Optometrist
  • Babylon, NY
  • NPI 1811044688
  Medicare reassignment Care Compare group NPD
• Christine Tam, OD

  • Optometrist
  • Manhasset, NY
  • NPI 1336590421
  Medicare reassignment Care Compare group
• Elizabeth Lutz

  • Optician
  • Massapequa, NY
  • NPI 1518469758
  NPD

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

{
    "created_epoch": "1520121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542326400000",
    "number": "1023510278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 SHOREHAM RD",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117587358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4644 MERRICK RD",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117586030",
            "telephone_number": "516-860-6659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE VISION LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-04",
        "last_updated": "2018-11-16",
        "status": "A",
        "authorized_official_last_name": "BURTON",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OPTICIAN/OWNER",
        "authorized_official_telephone_number": "516-860-6659"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "NY",
            "license": "007789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Shaw
• Keri Anne Shea, MASPED
• Kimberly Jean Shea, MA
• David Sherlock, DO
• Shore Smiles Dental, PC
• Steven Mark Shoum, MD
• Talia Nicol Shwer, D.P.M.
• Michael Sicignano, P.T.
• Kainaat Siddiqui, RPH
• Elliot B Siegel, DDS

• Preferred Provider Organization in Massapequa, NY
• Providers in Massapequa, NY by specialty
• Preferred Provider Organization in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2018; 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.