Individual provider Active NPI

Laura Guttman, OD

  • Optometrist
  • Staten Island, NY
National Provider Identifier
1124478300
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
008426 Issued in NY
Practice address
2791 Richmond Ave
Staten Island, NY 10314-5882
Phone
(718) 494-9257
NPI assigned
Jun 17, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 008426 NY Primary

Addresses

Primary practice location

2791 Richmond Ave
Staten Island, NY 10314-5882

Mailing address

2791 Richmond Ave
Staten Island, NY 10314-5882

Other identifiers 1

IdentifierTypeStateIssuer
008426OtherNYNEW YORK OD

Other names 1

  • Laura Zavilensky Former name

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
I20160902001302 NY Practitioner - Optometry 8224263678 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008426NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Clear Sight Optical Corp. Optometrist CurrentSince Mar 2, 2016 Accepting new patients
Clear Sight Optical Corp Optometrist Current Accepting new patients

Locations

1101 Amboy Ave
Edison, NJ 08837
Phone (718) 477-6700

1101 Amboy Ave
Fl 2
Edison, NJ 08837

2791 Richmond Ave
Staten Island, NY 10314
Phone (718) 494-9257

Organizations & group practices 2

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": "1466121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1124478300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2791 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2791 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145882",
            "telephone_number": "718-494-9257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTTMAN",
        "first_name": "LAURA",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-17",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "008426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK OD",
            "identifier": "008426",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "ZAVILENSKY",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.