Active NPI
Kaushal Kannammal, O. D.
- Optometrist
- Jamaica, NY
National Provider Identifier
1063863793
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 008447
- Practice address
- 13750 Jamaica Ave
Jamaica, NY 11435-3610 - Phone
- (718) 298-5100
- NPI assigned
- Jun 23, 2016
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 008447 | NY | Primary |
Addresses
Primary practice location
13750 Jamaica Ave
Jamaica, NY 11435-3610
Mailing address
13750 Jamaica Ave
Jamaica, NY 11435-3610
Phone (718) 298-5100
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008447 | NY | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Damian Family Care Centers, Inc. | Current | Accepting new patients | |
| Damian Family Care Centers, Inc. | Current | Accepting new patients | |
| Ny Comprehensive Medical Wellness P.C. | Past | Accepting new patients | |
| America'S Best Contacts & Eyeglasses | Past | Accepting new patients |
Locations
2604 3rd Ave
Bronx, NY 10454
Phone (718) 292-0100
8956 162nd St
#3
Jamaica, NY 11432
Phone (718) 297-8000
13750 Jamaica Ave
Jamaica, NY 11435
Phone (718) 298-5100
Interoperability endpoints
- kaushal.chinnusamy@damian.eclinicaldirectplus.com
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.
-
- Federally Qualified Health Center (FQHC)
- Jamaica, NY
- NPI 1508955592
-
- Federally Qualified Health Center (FQHC)
- Jamaica, NY
- NPI 1487923595
-
- Eyewear Supplier
- Blasdell, NY
- NPI 1730110453
-
- Dermatopathology Physician
- Bronx, NY
- NPI 1912419698
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742860800000",
"number": "1063863793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13750 JAMAICA AVE",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114353610",
"telephone_number": "718-298-5100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13750 JAMAICA AVE",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114353610",
"telephone_number": "718-298-5100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANNAMMAL",
"first_name": "KAUSHAL",
"name_prefix": "Dr.",
"credential": "O. D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-23",
"last_updated": "2025-03-25",
"certification_date": "2025-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "008447",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.