Organization Active NPI

Ophthalmology Associates of Queens PC

  • Ophthalmology Physician
  • Astoria, NY
National Provider Identifier
1124214499
Registry record updated Dec 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
OPHTHALMOLOGY ASSOCIATES OF QUEENS PC
Practice address
3074 36TH St
Astoria, NY 11103-4705
Phone
(718) 728-0224
Fax
(718) 728-1626
NPI assigned
Sep 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2007

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

Authorized official

Name
Melvin Lee Haller, MDNPI 1124015946
Title
MD President and Owner
Phone
(718) 728-0224

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
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

3074 36TH St
Astoria, NY 11103-4705

Mailing address

3074 36TH St
Astoria, NY 11103-4705
Phone (718) 728-0224

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041220000053 NY Part B Supplier - Clinic/Group Practice 4385601582 Receives reassigned benefits from 2 practitioners
Practice locations: Astoria, NY

National Provider Directory

National Provider Directory

Locations

3074 36th St
Long Island City, NY 11103
Phone (201) 951-0496

Practitioners & affiliated clinicians

Practitioners 2

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": "1190246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197331200000",
    "number": "1124214499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3074 36TH ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111034705",
            "telephone_number": "718-728-0224",
            "fax_number": "718-728-1626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3074 36TH ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111034705",
            "telephone_number": "718-728-0224",
            "fax_number": "718-728-1626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPHTHALMOLOGY ASSOCIATES OF QUEENS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-20",
        "last_updated": "2007-12-11",
        "status": "A",
        "authorized_official_last_name": "HALLER",
        "authorized_official_first_name": "MELVIN",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "MD PRESIDENT AND OWNER",
        "authorized_official_telephone_number": "718-728-0224",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.