Robert Grzesiak, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

VUT-005977-1 Issued in NY

Practice address

160 Walt Whitman Rd # a
Huntington Station, NY 11746-4130

Phone

(631) 351-5355

NPI assigned

May 3, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Long Island Vision and Contact Lens Services, Inc.

  • Optometrist
  • Huntington Station, NY
  • NPI 1134892763
  Medicare reassignment NPD

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073735783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 BALSAM DR",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117467724",
            "telephone_number": "631-423-7026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 WALT WHITMAN RD # A",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117464130",
            "telephone_number": "631-351-5355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRZESIAK",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "VUT-005977-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Greenbaum, LCSW
• Lucille Marie Grello
• David Groden
• Amanda Lea Grodewald-Adler, PSY.D.
• Katherine Grudens
• Elisa Marie Guerriere
• Nadege Guirand, LPN
• Tuesday N Gundersen
• Christa Beth Gundrum
• Jinjun Guo, LAC

• Optometrist in Huntington Station, NY
• Providers in Huntington Station, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.