Individual provider Active NPI

Joseph Hallak, OD

  • Optometrist
  • Hicksville, NY
National Provider Identifier
1063477602
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T003362 Issued in NY
Practice address
183 Broadway
Suite 308
Hicksville, NY 11801-4247
Phone
(516) 935-0717
Fax
(516) 935-0717
NPI assigned
Apr 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 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 T003362 NY Primary

Addresses

Primary practice location

183 Broadway
Suite 308
Hicksville, NY 11801-4247

Mailing address

183 Broadway
Suite 308
Hicksville, NY 11801-4247
Phone (516) 935-0717

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
I20041109001259 NY Practitioner - Optometry 6406819507 Reassigns benefits to 1 organization
Practice locations: Syosset, NY

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6 Clearland Rd
Syosset, NY 11791-6914
Phone (516) 935-0717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T003362NYMDOptometrist
003362NYMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Nassau Health Care Corporation CurrentSince Jan 5, 2010 Accepting new patients
Nassau Health Care Corporation Current Accepting new patients
Nassau Health Care Corporation CurrentSince Jan 5, 2010 Accepting new patients
Jhallak Syosset Optometry, P.C. Optometrist CurrentSince Dec 1, 2020 Accepting new patients
Joseph Hallak PastSince Apr 1, 1995 Accepting new patients
Joseph Bacotti MD PC Past Accepting new patients

Locations

2201 Hempstead Tpke
Rm 2448
East Meadow, NY 11554
Phone (516) 572-1234

2201 Hempstead Tpke
East Meadow, NY 11554
Phone (516) 486-6862

Organizations & group practices 6

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": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1063477602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 BROADWAY",
            "address_2": "SUITE 308",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118014247",
            "telephone_number": "516-935-0717",
            "fax_number": "516-935-0717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 BROADWAY",
            "address_2": "SUITE 308",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118014247",
            "telephone_number": "516-935-0717",
            "fax_number": "516-935-0717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLAK",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "T003362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hicksville, NY

Sources for this page

Verify at the official NPI Registry.