Organization Active NPI

Ma Ophthalmology, PLLC

  • Ophthalmology Physician
  • Flushing, NY
National Provider Identifier
1104491844
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
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, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Authorized official

Name
Dr. Laiyin Ma, MDNPI 1073900353
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)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
05763199MedicaidNY

Other names 1

  • Envision Eye Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220830002215 NY Part B Supplier - Clinic/Group Practice 5395129019 Receives reassigned benefits from 2 practitioners
Practice locations: Flushing, NY

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.

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.

Verify at the official NPI Registry.