Organization Active NPI

Miles & Tisch Eyecare Associates LTD

  • Optometrist
  • New York, NY
National Provider Identifier
1033390844
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV005672-01 Issued in NY
Legal business name
MILES & TISCH EYECARE ASSOCIATES LTD
Practice address
244 West 54TH Street
Suite, 402
New York, NY 10019-5704
Phone
(212) 765-2660
Fax
(212) 765-2714
NPI assigned
Nov 20, 2007
Last updated
Mar 29, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Authorized official

Name
Mr. Craig Brian Tisch, ODNPI 1346316718
Title
Optometrist
Phone
(212) 765-2660

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV005672-01 NY Primary

Addresses

Primary practice location

244 West 54TH Street
Suite, 402
New York, NY 10019-5704

Mailing address

244 West 54TH Street
Suite, 402
New York, NY 10019-5704
Phone (212) 765-2660

Other identifiers 1

IdentifierTypeStateIssuer
01777128MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111206000209 NY Part B Supplier - Clinic/Group Practice 2668361635 Receives reassigned benefits from 3 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

888 8th Ave
New York, NY 10019
Phone (212) 765-2660

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616976000000",
    "number": "1033390844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 WEST 54TH STREET",
            "address_2": "SUITE, 402",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100195704",
            "telephone_number": "212-765-2660",
            "fax_number": "212-765-2714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 WEST 54TH STREET",
            "address_2": "SUITE, 402",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100195704",
            "telephone_number": "212-765-2660",
            "fax_number": "212-765-2714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILES & TISCH EYECARE ASSOCIATES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-20",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A",
        "authorized_official_last_name": "TISCH",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "212-765-2660",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV005672-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01777128",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.