NPIMap

Organization Active NPI

Sioc@Bay St Optical Pavilion

Doing business as Bay Street Optical Pavilion

  • Optometrist
  • Staten Island, NY
National Provider Identifier
1154594190
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV004813-1 Issued in NY
Legal business name
SIOC@BAY ST OPTICAL PAVILION
Doing business as
Bay Street Optical Pavilion
Practice address
664 Bay St
Optical
Staten Island, NY 10304-3829
Phone
(718) 727-5678
NPI assigned
Apr 10, 2008
Last updated
Apr 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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

Authorized official

Name
Dr. Carolyn Rosemary Powell Rivers, ODNPI 1598741076
Title
Principle
Phone
(718) 727-5678

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X TUV004813-1 NY Primary

Addresses

Primary practice location

664 Bay St
Optical
Staten Island, NY 10304-3829

Mailing address

664 Bay St
Optical
Staten Island, NY 10304-3829

Other names 1

  • Bay Street Optical Pavilion Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1154594190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "664 BAY ST",
            "address_2": "OPTICAL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103043829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "664 BAY ST",
            "address_2": "OPTICAL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103043829",
            "telephone_number": "718-727-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIOC@BAY ST OPTICAL PAVILION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-10",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "POWELL RIVERS",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "ROSEMARY",
        "authorized_official_title_or_position": "PRINCIPLE",
        "authorized_official_telephone_number": "718-727-5678",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV004813-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bay Street Optical Pavilion",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; 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.