Individual provider Active NPI

Alyssa Keller, OD

  • Optometrist
  • New York, NY
National Provider Identifier
1083596084
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
011226 Issued in NY
Practice address
950 3Rd Ave FL 3
New York, NY 10022-2793
Phone
(212) 861-9797
NPI assigned
Jul 22, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 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 011226 NY Primary

Addresses

Primary practice location

950 3Rd Ave FL 3
New York, NY 10022-2793

Mailing address

15 Broad St Apt 828
New York, NY 10005-1963
Phone (479) 899-1358

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
I20250818002271 NY Practitioner - Optometry 7517466477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vitreous Retina Macula Consultants of New YorkGroup PAC ID 3375432628, 11 clinicians

Practice addresses (Care Compare)

110 Lafayette St
RM 502
New York, NY 10013-4116
Phone (646) 417-5971

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011226NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vitreous Retina Macula Consultants of New York CurrentSince Aug 11, 2025 Accepting new patients

Locations

902 Quentin Rd
#601
Brooklyn, NY 11223
Phone (718) 376-3223

110 Lafayette St
Rm 502
New York, NY 10013
Phone (212) 861-9797

950 3rd Ave
Fl 3
New York, NY 10022
Phone (212) 861-9797

Interoperability endpoints

  • Direct secure messaging: akeller@vrmny.intellechartdirect.net

Organizations & group practices 1

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": "1753142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1083596084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 BROAD ST APT 828",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100051963",
            "telephone_number": "479-899-1358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 3RD AVE FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100222793",
            "telephone_number": "212-861-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "ALYSSA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-22",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "011226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.