Active NPI
Peter Martinez, OPTICIAN
- Optician
- New Hyde Park, NY
National Provider Identifier
1043066657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 007944-01
- Practice address
- 2090B Hillside Ave
New Hyde Park, NY 11040-2613 - Phone
- (516) 358-4040
- Fax
- (516) 358-7465
- NPI assigned
- Apr 25, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 007944-01 | NY | Primary |
Addresses
Primary practice location
2090B Hillside Ave
New Hyde Park, NY 11040-2613
Mailing address
2090B Hillside Ave
New Hyde Park, NY 11040-2613
Phone (516) 358-4040
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007944-01 | NY | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optical Factory | Optician | Past | Accepting new patients |
Organizations & group practices 1
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": "1714003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714003200000",
"number": "1043066657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2090B HILLSIDE AVE",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "110402613",
"telephone_number": "516-358-4040",
"fax_number": "516-358-7465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2090B HILLSIDE AVE",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "110402613",
"telephone_number": "516-358-4040",
"fax_number": "516-358-7465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "PETER",
"name_prefix": "Mr.",
"credential": "OPTICIAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-04-25",
"last_updated": "2024-04-25",
"certification_date": "2024-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NY",
"license": "007944-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Hyde Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.