Individual provider Active NPI

Gary Eppel, O.D.

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1114034774
Registry record updated Nov 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV006232 Issued in NY
Practice address
1714 Avenue M
Brooklyn, NY 11230-5304
Phone
(718) 375-4300
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV006232 NY Primary

Addresses

Primary practice location

1714 Avenue M
Brooklyn, NY 11230-5304

Mailing address

2552 E.11 Street
2ND Floor
Brooklyn, NY 11235
Phone (646) 831-7424

Other identifiers 1

IdentifierTypeStateIssuer
02082768MedicaidNY

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
I20040708000872 NY Practitioner - Optometry 7618955568 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2000
Medicare assignment
May accept Medicare assignment
Group practices
Brooklyn Vista Site Eyecare Inc.Group PAC ID 0345492807, 2 clinicians

Practice addresses (Care Compare)

1913 Kings Hwy
Brooklyn, NY 11229-1313
Phone (646) 831-7424

5144 Kings PLZ
Suite 128
Brooklyn, NY 11234-5214
Phone (718) 253-0100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006232NYMDRegistered Dietitian
TUV006232NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Alleyes Inc Optometrist CurrentSince Feb 22, 2015 Accepting new patients
Brooklyn Vista Site Eyecare Inc. Optometrist CurrentSince Aug 1, 2020 Accepting new patients
Kings Vistasite Eyecare Inc. Optometrist CurrentSince Mar 22, 2020 Accepting new patients

Locations

1913 Kings Hwy
Brooklyn, NY 11229
Phone (646) 831-7424

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196035200000",
    "number": "1114034774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2552 E.11 STREET",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11235",
            "telephone_number": "646-831-7424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1714 AVENUE M",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305304",
            "telephone_number": "718-375-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPPEL",
        "first_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2007-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02082768",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.