Active NPI
Ma Ophthalmology, PLLC
- Ophthalmology Physician
- Flushing, NY
National Provider Identifier
1104491844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- Legal business name
- MA OPHTHALMOLOGY, PLLC
- Practice address
- 3616 Main St FL 9
Flushing, NY 11354-4105 - Phone
- (917) 667-2655
- NPI assigned
- May 25, 2021
- Organization subpart
- Yes
- Parent organization
- MA OPHTHALMOLOGY, PLLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Laiyin Ma, MD
- Title
- Owner
- Phone
- (917) 667-2655
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | Primary |
Addresses
Primary practice location
3616 Main St FL 9
Flushing, NY 11354-4105
Mailing address
69 Eakins Rd
Manhasset, NY 11030-2632
Phone (917) 667-2655
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05763199 | Medicaid | NY |
Other names 1
- Envision Eye Group
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
National Provider Directory
National Provider Directory- Part of
- Ma Ophthalmology PLLC
Locations
3618 Main St
Fl 9
Flushing, NY 11354
Phone (718) 888-1513
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Ophthalmology Physician
- New York, NY
- NPI 1073900353
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621900800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1659398400000",
"number": "1104491844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "69 EAKINS RD",
"city": "MANHASSET",
"state": "NY",
"postal_code": "110302632",
"telephone_number": "917-667-2655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3616 MAIN ST FL 9",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113544105",
"telephone_number": "917-667-2655"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MA OPHTHALMOLOGY, PLLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MA OPHTHALMOLOGY, PLLC",
"enumeration_date": "2021-05-25",
"last_updated": "2022-08-02",
"certification_date": "2022-08-02",
"status": "A",
"authorized_official_last_name": "MA",
"authorized_official_first_name": "LAIYIN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "917-667-2655",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "05763199",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Envision Eye Group",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Envision Eye Group",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; 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.