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Ophthalmic Consultants of Long Island

Organization Active NPI Durable Medical Equipment & Medical Supplies · Huntington, NY

NPI 1154830701 · NPPES record last updated Jun 26, 2019

Key facts

NPI
1154830701
Entity type
Organization (NPI type 2)
Primary specialty
Durable Medical Equipment & Medical Supplies 332B00000X
Legal business name
OPHTHALMIC CONSULTANTS OF LONG ISLAND
Practice address
1700 E Jericho Tpke
Huntington, NY 11743-5614
Phone
(631) 462-2020
NPI assigned
Sep 27, 2017
Organization subpart
No

Authorized official

Name
Bonnie Wright
Title
Credentialing Coordinator
Phone
(516) 804-5200

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 107

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 107

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D1031972Ophthalmic Consultants of Long Island
1700 East Jericho Turnpike, Huntington, NY 11743		Certificate of waiverJan 30, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Ophthalmic Consultants of Long Isla
1700 E Jericho Tpke, Huntington, NY 11743-5614 · (631) 462-2020		 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignment
Participating since Jul 1, 1997

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20180126002503 NY DME Supplier - Physician - General Practice
DME Supplier - Optician		 8022909076 Practice locations: Huntington, NY

National Provider Directory

Tax ID family
Avi Wallerstein MD (4 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Yes

Addresses

Primary practice location

1700 E Jericho Tpke
Huntington, NY 11743-5614

Mailing address

825 E Gate Blvd Ste 111
Garden City, NY 11530-2136
Phone (516) 804-5200

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 26, 2019.

{
    "created_epoch": "1506470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561507200000",
    "number": "1154830701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 E GATE BLVD STE 111",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302136",
            "telephone_number": "516-804-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E JERICHO TPKE",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117435614",
            "telephone_number": "631-462-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPHTHALMIC CONSULTANTS OF LONG ISLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-27",
        "last_updated": "2019-06-26",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "516-804-5200"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

All providers in Huntington, NY · Durable Medical Equipment & Medical Supplies in New York

Sources for this page

Verify at the official NPI Registry.