Organization Active NPI

Little Miss Optical Inc

  • Optometrist
  • Little Neck, NY
National Provider Identifier
1073370789
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
LITTLE MISS OPTICAL INC
Practice address
5604 Marathon Pkwy
Little Neck, NY 11362-2034
Phone
(718) 423-8937
NPI assigned
Feb 29, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Authorized official

Name
Edward KongNPI 1851797831
Title
Owner
Phone
(718) 423-3837

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

5604 Marathon Pkwy
Little Neck, NY 11362-2034

Mailing address

5604 Marathon Pkwy
Little Neck, NY 11362-2034
Phone (718) 423-8937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240412000995 NY Part B Supplier - Clinic/Group Practice 0446699235 Receives reassigned benefits from 1 practitioner
Practice locations: Little Neck, NY

National Provider Directory

National Provider Directory

Locations

5604 Marathon Pkwy
Little Neck, NY 11362
Phone (718) 423-3937

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1709164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709164800000",
    "number": "1073370789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5604 MARATHON PKWY",
            "city": "LITTLE NECK",
            "state": "NY",
            "postal_code": "113622034",
            "telephone_number": "718-423-8937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5604 MARATHON PKWY",
            "city": "LITTLE NECK",
            "state": "NY",
            "postal_code": "113622034",
            "telephone_number": "718-423-8937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE MISS OPTICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-29",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A",
        "authorized_official_last_name": "KONG",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-423-3837"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.