Ny Optometrist Vision PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV008487 Issued in NY

Legal business name

NY OPTOMETRIST VISION PC

Practice address

15036 Union Tpke
Flushing, NY 11367-3928

Phone

(718) 591-3000

NPI assigned

May 21, 2018

Organization subpart

No

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

Authorized official

Name

Leonard Fuzaylov, O.D.NPI 1225480296

Title

Owner

Phone

(718) 591-3000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

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

• Leonard Fuzaylov, O.D

  • Optometrist
  • Flushing, NY
  • NPI 1225480296
  Medicare reassignment NPD Authorized official
• Anna Khesin, OD

  • Optometrist
  • South Richmond Hill, NY
  • NPI 1912429226
  Medicare reassignment NPD

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

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560902400000",
    "number": "1174014591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15036 UNION TPKE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113673928",
            "telephone_number": "718-591-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15036 UNION TPKE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113673928",
            "telephone_number": "718-591-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NY OPTOMETRIST VISION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-21",
        "last_updated": "2019-06-19",
        "status": "A",
        "authorized_official_last_name": "FUZAYLOV",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-591-3000",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV008487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Flushing, NY
• Providers in Flushing, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.