Individual provider Active NPI

Justin Wu, O.D

  • Optometrist
  • Flushing, NY
National Provider Identifier
1093257453
Registry record updated Nov 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
008531 Issued in NY
Practice address
14355 41St Ave Apt 5C
Flushing, NY 11355-1821
Phone
(718) 886-8830
Fax
(718) 886-8825
NPI assigned
Nov 15, 2016
Last updated
Nov 15, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 008531 NY Primary

Addresses

Primary practice location

14355 41St Ave Apt 5C
Flushing, NY 11355-1821

Mailing address

13443 Maple Ave Ste 1C
Flushing, NY 11355-4695
Phone (718) 886-8830

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
I20190204001052 NY Practitioner - Optometry 1153668801 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Visionary Optometry PLLCGroup PAC ID 2264762087, 3 clinicians

Practice addresses (Care Compare)

13336 37TH Ave
G6
Flushing, NY 11354-4419
Phone (718) 340-3488

21818 Jamaica Ave
Queens Village, NY 11428-2125
Phone (718) 470-2277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008531NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Optometry PLLC Optometrist CurrentSince Nov 2, 2022 Accepting new patients
Noon Optometry PLLC Optometrist CurrentSince Jan 7, 2022 Accepting new patients
Elena Feldman Optometrist PC Optometrist CurrentSince Jul 21, 2019 Accepting new patients
Visionary Optometry, PLLC Optometrist CurrentSince Sep 1, 2019 Accepting new patients
Eyecare by Ophthalmologist, PLLC PastSince May 1, 2008 Accepting new patients
Ophthalmic Consultant, PLLC PastSince Aug 1, 2014 Accepting new patients

Locations

3730 E Tremont Ave
Bronx, NY 10465
Phone (718) 792-9590

187 Avenue U
Brooklyn, NY 11223
Phone (718) 373-2020

2504 Flatbush Ave
Brooklyn, NY 11234
Phone (718) 253-7700

21818 Jamaica Ave
Queens Vlg, NY 11428
Phone (347) 860-9360

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1479168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479168000000",
    "number": "1093257453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13443 MAPLE AVE STE 1C",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113554695",
            "telephone_number": "718-886-8830",
            "fax_number": "718-886-8825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14355 41ST AVE APT 5C",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113551821",
            "telephone_number": "718-886-8830",
            "fax_number": "718-886-8825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "JUSTIN",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-15",
        "last_updated": "2016-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "008531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.