Individual provider Active NPI

Soney Tino Siriphone, O.D.

  • Optometrist
  • Jamaica, NY
National Provider Identifier
1053769141
Registry record updated Jan 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
008459 Issued in NY
Practice address
9704 Sutphin Blvd
Jamaica, NY 11435-4721
Phone
(718) 657-7088
Fax
(718) 657-7092
NPI assigned
May 30, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 008459 NY Primary

Addresses

Primary practice location

9704 Sutphin Blvd
Jamaica, NY 11435-4721

Mailing address

60 Madison Ave
New York, NY 10010-1600
Phone (212) 545-2400

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
I20190104001403 NY Practitioner - Optometry 9234475708 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation CurrentSince May 18, 2023 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince May 18, 2023 Accepting new patients
New York City Health and Hospitals Corporation Current Accepting new patients

Locations

815 Broadway
Brooklyn, NY 11206
Phone (646) 614-8200

3750 72nd St
Jackson Heights, NY 11372
Phone (646) 615-7800

8268 164th St
Jamaica, NY 11432
Phone (718) 883-2929

50 Water St
Fl 3
New York, NY 10004

227 Madison St
Fl First
New York, NY 10002
Phone (212) 238-7071

227 Madison St
New York, NY 10002
Phone (212) 238-7000

Interoperability endpoints

  • Direct secure messaging: ssiriphone@bewell.direct.eyemdemr.com
  • Direct secure messaging: ssiriphone2111315@nychhc.direct-ci.com

Organizations & group practices 3

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": "1464566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1053769141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100101600",
            "telephone_number": "212-545-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9704 SUTPHIN BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114354721",
            "telephone_number": "718-657-7088",
            "fax_number": "718-657-7092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRIPHONE",
        "first_name": "SONEY",
        "middle_name": "TINO",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-30",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "008459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.