Organization Active NPI

Dr Nisim Pilosov Optometrist PLLC

  • Optometrist
  • Corona, NY
National Provider Identifier
1104618651
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DR NISIM PILOSOV OPTOMETRIST PLLC
Practice address
9905 59TH Ave Apt 3E
Corona, NY 11368-3825
Phone
(347) 407-2042
NPI assigned
May 20, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Authorized official

Name
Dr. Nisim Pilosov, ODNPI 1023893401
Title
Optometrist
Phone
(347) 407-2042

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

9905 59TH Ave Apt 3E
Corona, NY 11368-3825

Mailing address

9905 59TH Ave Apt 3E
Corona, NY 11368-3825
Phone (347) 407-2042

National Provider Directory

National Provider Directory

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": "1747699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747699200000",
    "number": "1104618651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9905 59TH AVE APT 3E",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113683825",
            "telephone_number": "347-407-2042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9905 59TH AVE APT 3E",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113683825",
            "telephone_number": "347-407-2042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR NISIM PILOSOV OPTOMETRIST PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-20",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A",
        "authorized_official_last_name": "PILOSOV",
        "authorized_official_first_name": "NISIM",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "347-407-2042",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.