Organization Active NPI

Halikiopoulos Ophthalmology, PC

  • Ophthalmology Physician
  • Great Neck, NY
National Provider Identifier
1093738437
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
217146 Issued in NY
Legal business name
HALIKIOPOULOS OPHTHALMOLOGY, PC
Practice address
107 Northern Blvd
Suite 205
Great Neck, NY 11021-4309
Phone
(516) 466-4670
Fax
(516) 466-4675
NPI assigned
Jul 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Demetrios Halikiopoulos, DONPI 1467453506
Title
Owner
Phone
(516) 466-4670

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
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 217146 NY Primary

Addresses

Primary practice location

107 Northern Blvd
Suite 205
Great Neck, NY 11021-4309

Mailing address

107 Northern Blvd
Suite 205
Great Neck, NY 11021-4309
Phone (516) 466-4670

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050406000116 NY Part B Supplier - Clinic/Group Practice 3173570769 Receives reassigned benefits from 1 practitioner
Practice locations: Great Neck, NY

National Provider Directory

National Provider Directory

Locations

107 Northern Blvd
Ste 205
Great Neck, NY 11021
Phone (516) 466-4670

Practitioners & affiliated clinicians

Practitioners 1

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": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093738437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 NORTHERN BLVD",
            "address_2": "SUITE 205",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214309",
            "telephone_number": "516-466-4670",
            "fax_number": "516-466-4675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 NORTHERN BLVD",
            "address_2": "SUITE 205",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214309",
            "telephone_number": "516-466-4670",
            "fax_number": "516-466-4675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALIKIOPOULOS OPHTHALMOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HALIKIOPOULOS",
        "authorized_official_first_name": "DEMETRIOS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-466-4670",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "217146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.