Individual provider Active NPI

Stuart Michael Rappaport, O.D.

  • Optometrist
  • Cedarhurst, NY
National Provider Identifier
1053416909
Registry record updated Dec 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV003912-1 Issued in NY
Practice address
538 Central Ave
Cedarhurst, NY 11516-2127
Phone
(516) 374-1010
Fax
(516) 374-4383
NPI assigned
Sep 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 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 TUV003912-1 NY Primary

Addresses

Primary practice location

538 Central Ave
Cedarhurst, NY 11516-2127

Mailing address

538 Central Ave
Cedarhurst, NY 11516-2127
Phone (516) 374-1010

Other identifiers 1

IdentifierTypeStateIssuer
00483050MedicaidNY

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
I20110729000276 NY Practitioner - Optometry 4385756022 Reassigns benefits to 3 organizations
Practice locations: Cedarhurst, NY; Far Rockaway, NY; Flushing, NY

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jacob C Shafran Optometry PLLCGroup PAC ID 9032557145, 4 clinicians

Practice addresses (Care Compare)

14461 38TH Ave
Flushing, NY 11354-5935
Phone (212) 739-1799

538 Central Ave
Cedarhurst, NY 11516-2127
Phone (516) 374-1010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV003912-1NYMDOptometrist
003912NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Associates of the Five Towns, Inc. Optometrist CurrentSince Jun 13, 2011 Accepting new patients
Visual Optometry PLLC Optometrist CurrentSince Mar 15, 2024 Accepting new patients
Central Vision Care Optometry and Ophthalmic Dispensing PLLC Optometrist CurrentSince Jun 13, 2011 Accepting new patients
Wise Medical Ny PC Optometrist CurrentSince Oct 27, 2018 Accepting new patients

Locations

311 W 231st St
Bronx, NY 10463
Phone (718) 601-8400

5314 16th Ave
Brooklyn, NY 11204
Phone (855) 629-2431

2107 Ditmas Ave
Brooklyn, NY 11226
Phone (718) 207-4348

6326 New Utrecht Ave
Brooklyn, NY 11219
Phone (212) 739-1799

538 Central Ave
Cedarhurst, NY 11516
Phone (516) 374-1010

14461 38th Ave
Flushing, NY 11354
Phone (212) 739-1799

Organizations & group practices 4

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197331200000",
    "number": "1053416909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "538 CENTRAL AVE",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115162127",
            "telephone_number": "516-374-1010",
            "fax_number": "516-374-4383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "538 CENTRAL AVE",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115162127",
            "telephone_number": "516-374-1010",
            "fax_number": "516-374-4383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAPPAPORT",
        "first_name": "STUART",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV003912-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00483050",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedarhurst, NY

Sources for this page

Verify at the official NPI Registry.