Organization Active NPI

Sajo Optometric Care, PLLC

  • Optometrist
  • Bronx, NY
National Provider Identifier
1124149760
Registry record updated Dec 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV006250-1 Issued in NY
Legal business name
SAJO OPTOMETRIC CARE, PLLC
Practice address
801 E 233Rd St
Bronx, NY 10466-3203
Phone
(347) 603-7125
Fax
(347) 603-7127
NPI assigned
Apr 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2007

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

Authorized official

Name
Dr. Owen J. Peters, O.D.NPI 1184724692
Title
Owner
Phone
(347) 603-7125

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X TUV006250-1 NY Primary

Addresses

Primary practice location

801 E 233Rd St
Bronx, NY 10466-3203

Mailing address

801 E 233Rd St
Bronx, NY 10466-3203
Phone (347) 603-7125

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040930000309 NY Part B Supplier - Clinic/Group Practice 9537138136 Receives reassigned benefits from 1 practitioner
Practice locations: Bronx, NY

National Provider Directory

National Provider Directory

Locations

801 E 233rd St
Bronx, NY 10466
Phone (347) 603-7125

Practitioners & affiliated clinicians

Practitioners 1

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": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197590400000",
    "number": "1124149760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 E 233RD ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104663203",
            "telephone_number": "347-603-7125",
            "fax_number": "347-603-7127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E 233RD ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104663203",
            "telephone_number": "347-603-7125",
            "fax_number": "347-603-7127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAJO OPTOMETRIC CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2007-12-14",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "OWEN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-603-7125",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006250-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2007; 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.