Chisom Iwuanyanwu, O.D

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV007637-1 Issued in NY

Practice address

217 14 Merrick Blvd
Laurelton, NY 11413-1726

Phone

(718) 978-0100

NPI assigned

Dec 9, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Donna Goukler OD PCGroup PAC ID 2769822477, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Donna Goukler, O.D., P.C.

  • Optometrist
  • Delmar, NY
  • NPI 1639860695
  Medicare reassignment Care Compare group NPD
• Bronx Vistasite Eyecare Inc

  • Optometrist
  • Bronx, NY
  • NPI 1114244563
  Medicare reassignment NPD

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

{
    "created_epoch": "1291852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1134422355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 14 MERRICK BLVD",
            "city": "LAURELTON",
            "state": "NY",
            "postal_code": "114131726",
            "telephone_number": "718-978-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 14 MERRICK BLVD",
            "city": "LAURELTON",
            "state": "NY",
            "postal_code": "114131726",
            "telephone_number": "718-978-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IWUANYANWU",
        "first_name": "CHISOM",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-09",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007637-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03556163",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathalie Monica Hyman-Gifth, RN
• Paulette Hyman
• Pauline Veronica Illidge
• Stella Ineama
• Island Musculoskeletal Care, M.D., P.C
• Olivia Monica Jackson
• Shawntay Jacques, LPN
• Adlie Jacquitte
• Kellee James, CHES
• Shantell E Jay

• Optometrist in Laurelton, NY
• Providers in Laurelton, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.