Individual provider Active NPI

Ellen J Brand, O.D.

  • Optometrist
  • New York, NY
National Provider Identifier
1114900321
Registry record updated Aug 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV004261-1 Issued in NY
Practice address
901 6TH Ave
Herald Square Optometric Associates (2ND Floor)
New York, NY 10001-3505
Phone
(212) 967-4177
Fax
(212) 967-2101
NPI assigned
Nov 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV004261-1 NY Primary

Addresses

Primary practice location

901 6TH Ave
Herald Square Optometric Associates (2ND Floor)
New York, NY 10001-3505

Mailing address

1323 Echo Hill Path
Yorktown Heights, NY 10598-5703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004261NYMDMental Health Counselor
TUV004261-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Herald Square Optometric Associates, P.C. Optometrist Past Accepting new patients

Organizations & group practices 1

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": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343865600000",
    "number": "1114900321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1323 ECHO HILL PATH",
            "city": "YORKTOWN HEIGHTS",
            "state": "NY",
            "postal_code": "105985703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 6TH AVE",
            "address_2": "HERALD SQUARE OPTOMETRIC ASSOCIATES (2ND FLOOR)",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100013505",
            "telephone_number": "212-967-4177",
            "fax_number": "212-967-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAND",
        "first_name": "ELLEN",
        "middle_name": "J",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-22",
        "last_updated": "2012-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV004261-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2012; 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.