Individual provider Active NPI

Kaushal Kannammal, O. D.

  • Optometrist
  • Jamaica, NY
National Provider Identifier
1063863793
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
008447 Issued in NY
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

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181128001958 NY Practitioner - Optometry 3870837057 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008447NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Damian Family Care Centers, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Damian Family Care Centers, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Ny Comprehensive Medical Wellness P.C. PastSince Dec 1, 2017 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.