Individual provider Active NPI

Grace Chiyu To, OD

  • Optometrist
  • Bronx, NY
National Provider Identifier
1114543527
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV009137 Issued in NY
Practice address
3130 Grand Concourse
Bronx, NY 10458-1213
Phone
(718) 749-3200
NPI assigned
Jun 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV009137 NY Primary

Addresses

Primary practice location

3130 Grand Concourse
Bronx, NY 10458-1213

Mailing address

8628 53Rd Ave
Elmhurst, NY 11373-4329
Phone (516) 965-8882

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
I20220113001565 NY Practitioner - Optometry 2365834801 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV009137NYMDOptometrist
009137NYMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MD Optics LLC CurrentSince Jul 5, 2023 Accepting new patients
Wilson Ko, M.D., F.a.C.S., P.C. CurrentSince Aug 4, 2022 Accepting new patients

Locations

13625 Maple Ave
Ste 202
Flushing, NY 11355
Phone (718) 358-5900

128 Mott St
Ste 408
New York, NY 10013
Phone (212) 732-0073

4413 Queens Blvd
Sunnyside, NY 11104
Phone (718) 784-2477

Interoperability endpoints

  • Direct secure messaging: gto@advancedeyecare.intellechartdirect.net

Organizations & group practices 2

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": "1592784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1114543527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8628 53RD AVE",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734329",
            "telephone_number": "516-965-8882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104581213",
            "telephone_number": "718-749-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TO",
        "first_name": "GRACE",
        "middle_name": "CHIYU",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-22",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV009137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.