Individual provider Active NPI

Farnoush Shahkohi, O.D.

  • Optometrist
  • Great Neck, NY
National Provider Identifier
1144204702
Registry record updated Apr 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV56006926 Issued in NY
Practice address
14 Morris LN
Great Neck, NY 11024-1707
Phone
(516) 707-5145
Fax
(347) 887-5000
NPI assigned
Dec 6, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV56006926 NY Primary

Addresses

Primary practice location

14 Morris LN
Great Neck, NY 11024-1707

Mailing address

14 Morris LN
Great Neck, NY 11024-1707
Phone (516) 707-5145

Other identifiers 1

IdentifierTypeStateIssuer
02707091MedicaidNY

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV56006926NYMDOptometrist
006926NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lafayette Medical Office, PC Optometrist Past Accepting new patients
Coney Island Family Eyecare Optometrist Past Accepting new patients
State of New York Comptrollers Office Past Accepting new patients

Organizations & group practices 3

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": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429056000000",
    "number": "1144204702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 MORRIS LN",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110241707",
            "telephone_number": "516-707-5145",
            "fax_number": "347-887-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 MORRIS LN",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110241707",
            "telephone_number": "516-707-5145",
            "fax_number": "347-887-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHKOHI",
        "first_name": "FARNOUSH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2015-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV56006926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02707091",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2015; 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.