Individual provider Active NPI

Michael Allen Kwartner, OPTICIAN

  • Optician
  • Woodbury, NY
National Provider Identifier
1124357710
Registry record updated Dec 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
4664 Issued in NY
Practice address
7948 Jericho Tpke
Woodbury, NY 11797-1204
Phone
(516) 364-1288
Fax
(516) 714-8600
NPI assigned
Dec 10, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 4664 NY Primary

Addresses

Primary practice location

7948 Jericho Tpke
Woodbury, NY 11797-1204

Mailing address

7948 Jericho Tpke
Woodbury, NY 11797-1204
Phone (516) 364-1288

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4664NYMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Allen Opticians Inc Optician PastSince Dec 29, 2024 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": "1260403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260403200000",
    "number": "1124357710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7948 JERICHO TPKE",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117971204",
            "telephone_number": "516-364-1288",
            "fax_number": "516-714-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7948 JERICHO TPKE",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117971204",
            "telephone_number": "516-364-1288",
            "fax_number": "516-714-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWARTNER",
        "first_name": "MICHAEL",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "OPTICIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-10",
        "last_updated": "2009-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "4664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2009; 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.