Individual provider Active NPI

Paul J Kantrowich, O.D.

  • Corneal and Contact Management Optometrist
  • New York, NY
National Provider Identifier
1114950094
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
TUV003325-1 Issued in NY
Practice address
420 Lexington Ave
New York, NY 10170-0002
Phone
(212) 697-0777
Fax
(212) 557-4414
NPI assigned
Jul 7, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X TUV003325-1 NY Primary

Addresses

Primary practice location

420 Lexington Ave
New York, NY 10170-0002

Mailing address

420 Lexington Ave
New York, NY 10170-0002
Phone (212) 697-0777

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
I20100224000701 NY Practitioner - Optometry 4183768450 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

405 Lexington Ave
New York, NY 10174-0002
Phone (212) 687-2054

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV003325-1NYMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Madison Avenue Eye Care LTD. PastSince Jul 16, 2023 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114950094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 LEXINGTON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101700002",
            "telephone_number": "212-697-0777",
            "fax_number": "212-557-4414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 LEXINGTON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101700002",
            "telephone_number": "212-697-0777",
            "fax_number": "212-557-4414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANTROWICH",
        "first_name": "PAUL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NY",
            "license": "TUV003325-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.