Individual provider Active NPI

Keith Beylus, O.D.

  • Optometrist
  • Flushing, NY
National Provider Identifier
1033214192
Registry record updated Dec 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUVOO5342-1 Issued in NY
Practice address
6750 164TH St
Flushing, NY 11365-3176
Phone
(718) 380-3280
NPI assigned
Sep 14, 2006
Last updated
Dec 18, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUVOO5342-1 NY Primary

Addresses

Primary practice location

6750 164TH St
Flushing, NY 11365-3176

Mailing address

6750 164TH St
Flushing, NY 11365-3176
Phone (718) 380-3280

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
I20050224000434 NY Practitioner - Optometry 1153374640 Practice locations: Staten Island, NY; Brooklyn, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUVOO5342-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gruen Optical Past Accepting new patients
Oda Primary Health Care Network, Inc. Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197936000000",
    "number": "1033214192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6750 164TH ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113653176",
            "telephone_number": "718-380-3280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6750 164TH ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113653176",
            "telephone_number": "718-380-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEYLUS",
        "first_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUVOO5342-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.