Individual provider Active NPI

Gerald Edward Wintrob, O.D.

  • Vision Therapy Optometrist
  • Brooklyn, NY
National Provider Identifier
1053450809
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vision Therapy OptometristTaxonomy code 152WV0400X
License
004342-1 Issued in NY
Practice address
40 8TH Ave
Brooklyn, NY 11217-3918
Phone
(718) 789-2020
Fax
(718) 789-0140
NPI assigned
Feb 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vision Therapy Optometrist 152WV0400X 004342-1 NY Primary

Addresses

Primary practice location

40 8TH Ave
Brooklyn, NY 11217-3918

Mailing address

40 8TH Ave
Brooklyn, NY 11217-3918
Phone (718) 789-2020

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
004342-1NYMDVision Therapy Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Balance Regenerative Sports and Rehabilitation Medicine PLLC CurrentSince Aug 1, 2021 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24624/brand/1/csg/1/fhir/r4

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053450809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 8TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112173918",
            "telephone_number": "718-789-2020",
            "fax_number": "718-789-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 8TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112173918",
            "telephone_number": "718-789-2020",
            "fax_number": "718-789-0140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINTROB",
        "first_name": "GERALD",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "NY",
            "license": "004342-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.