Individual provider Active NPI

Diana Lakovitsky, OD

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1164522645
Registry record updated Feb 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV006681 Issued in NY
Practice address
4818 13TH Ave
Kleins Vision Center
Brooklyn, NY 11219-3111
Phone
(718) 633-5162
Fax
(718) 633-0554
NPI assigned
Sep 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV006681 NY Primary

Addresses

Primary practice location

4818 13TH Ave
Kleins Vision Center
Brooklyn, NY 11219-3111

Mailing address

1644 W 12TH St
Brooklyn, NY 11223-1144
Phone (646) 642-3292

Other identifiers 1

IdentifierTypeStateIssuer
02557977MedicaidNY

Other names 1

  • Dr. Diana Lyakhovitskaya Former name

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
I20040729001011 NY Practitioner - Optometry 4981674694 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Modern Optika, IncGroup PAC ID 9234119397, 2 clinicians

Practice addresses (Care Compare)

453 Kings Hwy
Brooklyn, NY 11223-1847
Phone (718) 336-1060

Merit-based Incentive Payment System (MIPS)

Final score
93.4 of 100Reported as individual
Quality
66.8
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV006681NYMDOptometrist
006681NYMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Optika ,Inc CurrentSince Aug 1, 2012 Accepting new patients
New York Glaucoma Medical PC CurrentSince Jun 1, 2011 Accepting new patients
Lafayette Medical Office, PC Optometrist Past Accepting new patients
Joseph R. Podhorzer, MD, PLLC PastSince Jun 1, 2011 Accepting new patients
Modern Vision, Inc Optometrist PastSince Aug 1, 2012 Accepting new patients
Medcare, LLC Optometrist PastSince Nov 1, 2008 Accepting new patients
Gabe'S Pharmacy Inc. Past Accepting new patients

Locations

103 Quentin Rd
Ste G11
Brooklyn, NY 11223
Phone (718) 645-2201

Interoperability endpoints

  • Direct secure messaging: eye_lakovitsky@modernoptical.eyefinity-direct.com

Organizations & group practices 7

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": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328572800000",
    "number": "1164522645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1644 W 12TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112231144",
            "telephone_number": "646-642-3292",
            "fax_number": "718-633-0554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4818 13TH AVE",
            "address_2": "KLEINS VISION CENTER",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112193111",
            "telephone_number": "718-633-5162",
            "fax_number": "718-633-0554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKOVITSKY",
        "first_name": "DIANA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-24",
        "last_updated": "2012-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02557977",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "LYAKHOVITSKAYA",
            "prefix": "DR.",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.