NPIMap

Organization Active NPI

Legacy Optical Inc

  • Optician
  • Hampton Bays, NY
National Provider Identifier
1114515467
Registry record updated Jan 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
LEGACY OPTICAL INC
Practice address
4 Springville Rd Ste a
Hampton Bays, NY 11946-2290
Phone
(631) 875-4544
NPI assigned
Jan 4, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2021

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

Authorized official

Name
Mrs. Lisa R Pfleger, ABOCNPI 1801359146
Title
President/Nys Ophthalmic Dispenser
Phone
(631) 728-3132

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Contact Lens FitterGroup: 193200000X MULTI-SPECIALTY GROUP 156FC0801X
Optometric TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 156FX1202X
OpticianGroup: 193200000X MULTI-SPECIALTY GROUP 156FX1800X Primary

Addresses

Primary practice location

4 Springville Rd Ste a
Hampton Bays, NY 11946-2290

Mailing address

4 Springville Rd Ste a
Hampton Bays, NY 11946-2290
Phone (631) 875-4544

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210216001748 NY Part B Supplier - Clinic/Group Practice 9032524574 Receives reassigned benefits from 3 practitioners
Practice locations: Hampton Bays, NY

National Provider Directory

National Provider Directory

Locations

4 Springville Rd
Ste A
Hampton Bays, NY 11946
Phone (631) 728-3132

Practitioners & affiliated clinicians

Practitioners 4

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": "1609718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610150400000",
    "number": "1114515467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 SPRINGVILLE RD STE A",
            "city": "HAMPTON BAYS",
            "state": "NY",
            "postal_code": "119462290",
            "telephone_number": "631-875-4544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 SPRINGVILLE RD STE A",
            "city": "HAMPTON BAYS",
            "state": "NY",
            "postal_code": "119462290",
            "telephone_number": "631-875-4544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY OPTICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-04",
        "last_updated": "2021-01-09",
        "certification_date": "2021-01-09",
        "status": "A",
        "authorized_official_last_name": "PFLEGER",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT/NYS OPHTHALMIC DISPENSER",
        "authorized_official_telephone_number": "631-728-3132",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ABOC"
    },
    "taxonomies": [
        {
            "code": "156FC0801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Contact Lens Fitter",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156FX1202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optometric Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton Bays, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2021; 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.