Individual provider Active NPI

Gillian George, OD

  • Optometrist
  • Bronx, NY
National Provider Identifier
1114039302
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00592600 Issued in NJ
Practice address
2376 Grand Concourse
Bronx, NY 10458-6907
Phone
(718) 365-6300
Fax
(718) 365-5620
NPI assigned
Aug 31, 2006
Last updated
Dec 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT5016 MA
Optometrist 152W00000X 006888 NY
Optometrist 152W00000X 27OA00592600 NJ Primary
Optometrist 152W00000X 4070-35 WI
Optometrist 152W00000X OEG002886 PA
Optometrist 152W00000X OPT.0004101 CO
Optometrist 152W00000X 3940 MN
Optometrist 152W00000X OPT003056 GA

Addresses

Primary practice location

2376 Grand Concourse
Bronx, NY 10458-6907

Mailing address

406 Lydecker St
Englewood, NJ 07631-1914
Phone (201) 906-1376

Other practice location 1

475 Prospect Ave
West Orange, NJ 07052-4197
Phone (973) 325-3475

Other identifiers 2

IdentifierTypeStateIssuer
03498217MedicaidNY
0050865MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MA, PA, MN, GA, WI6 enrollments
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 6

Enrollment IDStateProvider typePAC IDDetails
I20181214001812 NY Practitioner - Optometry 2062479801 Reassigns benefits to 4 organizations
I20241213002328 MA Practitioner - Optometry 2062479801 Reassigns benefits to 1 organization
I20241217000671 PA Practitioner - Optometry 2062479801 Reassigns benefits to 4 organizations
I20241219000703 MN Practitioner - Optometry 2062479801 Reassigns benefits to 2 organizations
I20250114000938 GA Practitioner - Optometry 2062479801 Reassigns benefits to 2 organizations
I20251126004154 WI Practitioner - Optometry 2062479801 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 Vermont Dr
New Hyde Park, NY 11042-1128

4211 May Apple LN
Atlanta, GA 30349-8224

5 Dakota Dr
Suite 307
New Hyde Park, NY 11042-1188

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT.0004101COMDOptometrist
OPT003056GAMDOptometrist
27OA00592600NJMDOptometrist
006888NYMDOptometrist
OEG002886PAMDOptometrist
4070-35WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Pennsylvania, LLC Optometrist Current Accepting new patients
Visionworks, Inc. Optometrist CurrentSince Dec 27, 2024 Accepting new patients
Myeyedr Optometry of Pennsylvania, LLC Optometrist CurrentSince Dec 19, 2025 Accepting new patients
Myeyedr Optometry of Massachusetts P C Optometrist Current Accepting new patients
Visionworks, Inc. Optometrist CurrentSince Sep 6, 2025 Accepting new patients
200 West Optics, LLC Optometrist CurrentSince Jan 2, 2026 Accepting new patients
Chance Talley Enterprises LLC. CurrentSince Jan 14, 2025 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Dec 10, 2024 Accepting new patients
Best Vision, Inc Optometrist CurrentSince Sep 30, 2025 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Pennsylvania, LLC Optometrist CurrentSince Dec 19, 2025 Accepting new patients
Shoptikal LLC Optometrist CurrentSince Nov 17, 2025 Accepting new patients
Myeyedr Optometry of Massachusetts P C Optometrist CurrentSince Dec 10, 2024 Accepting new patients
Vitreous Retina Macula Consultants of New York CurrentSince Feb 1, 2025 Accepting new patients
Shoptikal LLC Optometrist Current Accepting new patients
Visionworks, Inc CurrentSince Dec 16, 2024 Accepting new patients
Empire Vision Center, Inc CurrentSince Dec 16, 2024 Accepting new patients
Empire Vision Center Inc Optometrist CurrentSince Dec 16, 2024 Accepting new patients
Myeyedr Optometry of Georgia LLC Optometrist CurrentSince Dec 10, 2024 Accepting new patients
Aeg Pennsylvania Professional Inc Optometrist CurrentSince Feb 1, 2025 Accepting new patients
Visionworks, Inc. Optometrist CurrentSince Dec 16, 2024 Accepting new patients
Myeyedr Optometry of Massachusetts P C Optometrist CurrentSince Dec 10, 2024 Accepting new patients
200 West Optics, LLC Optometrist CurrentSince Jan 2, 2026 Accepting new patients
Shoptikal LLC Optometrist CurrentSince Nov 17, 2025 Accepting new patients
Hull & Williquette, LTD CurrentSince Jan 8, 2026 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist Past Accepting new patients
Professional Eyecare Associates PA Optometrist Past Accepting new patients
Eyecare One LLC Optometrist Past Accepting new patients
Optical Outlet LLC Optometrist Past Accepting new patients

Locations (25 of 61)

2610 Dawson Rd
Albany, GA 31707
Phone (229) 439-4687

3440 Wrightsboro Rd
Augusta, GA 30909
Phone (706) 733-0020

207 Chestnut St
Bremen, GA 30110
Phone (770) 537-5246

4875 Altama Ave
Brunswick, GA 31520
Phone (912) 554-0010

806 Dixie St
Carrollton, GA 30117
Phone (770) 834-2071

911 N 3rd Ave
Chatsworth, GA 30705
Phone (706) 695-4676

4521 17th Ave
Columbus, GA 31904
Phone (706) 660-0191

2032 Veterans Blvd
Ste A
Dublin, GA 31021
Phone (478) 272-3445

3801 Northside Dr
Macon, GA 31210
Phone (478) 475-1600

503 Furys Ferry Rd
Martinez, GA 30907
Phone (706) 860-8899

1850 N Columbia St
Ste 5
Milledgeville, GA 31061
Phone (478) 453-0011

1601 Macon Rd
Perry, GA 31069
Phone (478) 218-0404

1014 Northside Dr E
Statesboro, GA 30458
Phone (912) 764-9147

15196 US Highway 19 S
Thomasville, GA 31757
Phone (229) 228-4770

198 S Houston Lake Rd
Ste B
Warner Robins, GA 31088
Phone (478) 971-1500

2209 Memorial Dr
Waycross, GA 31501
Phone (912) 285-2021

22 University Dr
Amherst, MA 01002
Phone (413) 549-9400

426 N Main St
East Longmeadow, MA 01028
Phone (413) 525-3010

489 Bernardston Rd
Greenfield, MA 01301
Phone (413) 772-2571

1178 Burnsville Ctr
#2036
Burnsville, MN 55306
Phone (952) 435-5011

902 Quentin Rd
#601
Brooklyn, NY 11223
Phone (718) 376-3223

2680 Delaware Ave
Ste C
Buffalo, NY 14216
Phone (716) 873-1241

12469 Olean Rd
Ste 1
Chaffee, NY 14030
Phone (716) 496-7454

2127 Crompond Rd
Ste 101
Cortlandt Mnr, NY 10567
Phone (914) 737-2020

560 Troy Schenectady Rd
#7
Latham, NY 12110
Phone (518) 783-0090

Organizations & group practices 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1114039302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 LYDECKER ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076311914",
            "telephone_number": "201-906-1376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2376 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104586907",
            "telephone_number": "718-365-6300",
            "fax_number": "718-365-5620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "475 Prospect Ave",
            "address_purpose": "LOCATION",
            "city": "West Orange",
            "state": "NJ",
            "postal_code": "070524197",
            "country_code": "US",
            "telephone_number": "973-325-3475",
            "fax_number": "973-325-3478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "GILLIAN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "OPT5016",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "006888",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00592600",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "4070-35",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002886",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT.0004101",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3940",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003056",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03498217",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0050865",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.