Bodim Optical Inc

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

007987 Issued in NY

Legal business name

BODIM OPTICAL INC

Doing business as

Pearle Vision

Practice address

1445 Hempstead Tpke
Elmont, NY 11003-2400

Phone

(516) 616-1771

NPI assigned

Feb 12, 2016

Last updated

Feb 12, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Boaz Ben-Jacob, DONPI 1720353667

Title

Ophthalmic Dispenser

Phone

(516) 616-1771

Specialties & licenses 1

Addresses

Other names 1

• PEARLE VISION Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Boaz Ben-Jacob

  • Optician
  • Elmont, NY
  • NPI 1720353667
  Authorized official Same address or phone

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

{
    "created_epoch": "1455235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455235200000",
    "number": "1124487616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 HEMPSTEAD TPKE",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110032400",
            "telephone_number": "516-616-1771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 HEMPSTEAD TPKE",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110032400",
            "telephone_number": "516-616-1771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODIM OPTICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-12",
        "last_updated": "2016-02-12",
        "status": "A",
        "authorized_official_last_name": "BEN-JACOB",
        "authorized_official_first_name": "BOAZ",
        "authorized_official_title_or_position": "OPHTHALMIC DISPENSER",
        "authorized_official_telephone_number": "516-616-1771",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "NY",
            "license": "007987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PEARLE VISION",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Point of Service in Elmont, NY
• Providers in Elmont, NY by specialty
• Point of Service in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2016; 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.