Individual provider Active NPI

Desmond Parkin, OD

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1164483673
Registry record updated Jun 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV0049261 Issued in NY
Practice address
196 Prospect PL
Brooklyn, NY 11238-3802
Phone
(718) 623-9122
Fax
(718) 623-9122
NPI assigned
Apr 1, 2006
Last updated
Jun 22, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV0049261 NY Primary

Addresses

Primary practice location

196 Prospect PL
Brooklyn, NY 11238-3802

Mailing address

196 Prospect PL
Brooklyn, NY 11238-3802
Phone (718) 623-9122

Other identifiers 1

IdentifierTypeStateIssuer
01110094MedicaidNY

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20071205000444 NY Practitioner - Optometry 7810086352 Reassigns benefits to 1 organization
Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4815 Church Ave
Brooklyn, NY 11203-3301
Phone (718) 282-8363

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004926NYMDPsychologist
TUV0049261NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Underground Eyewear Inc Optometrist CurrentSince Jul 1, 2009 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1143849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308700800000",
    "number": "1164483673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 PROSPECT PL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112383802",
            "telephone_number": "718-623-9122",
            "fax_number": "718-623-9128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 PROSPECT PL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112383802",
            "telephone_number": "718-623-9122",
            "fax_number": "718-623-9122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKIN",
        "first_name": "DESMOND",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-01",
        "last_updated": "2011-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV0049261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01110094",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.