Organization Active NPI

Advanced Eye Physician PLLC

  • Ophthalmology Physician
  • New York, NY
National Provider Identifier
1174600316
Registry record updated Nov 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
194271 Issued in NY
Legal business name
ADVANCED EYE PHYSICIAN PLLC
Practice address
99 Elizabeth Street, 2FL
New York, NY 10013
Phone
(212) 227-8837
NPI assigned
Nov 1, 2006
Last updated
Nov 15, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2019

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

Authorized official

Name
Nancy Tsai, MDNPI 1184732885
Title
Officer
Phone
(212) 227-8837

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU
Ophthalmology Physician 207W00000X 194271 NY Primary

Addresses

Primary practice location

99 Elizabeth Street, 2FL
New York, NY 10013

Mailing address

99 Elizabeth Street, 2FL
New York, NY 10013
Phone (212) 227-8837

Other practice location 1

4270 Kissena Blvd
Flushing, NY 11355-3213
Phone (718) 888-9838

Other identifiers 1

IdentifierTypeStateIssuer
02692015MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050303000939 NY Part B Supplier - Clinic/Group Practice 4981658853 Receives reassigned benefits from 9 practitioners
Practice locations: New York, NY; Flushing, NY

National Provider Directory

National Provider Directory

Locations

2 Mott St
Rm 206
New York, NY 10013
Phone (212) 227-4505

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573776000000",
    "number": "1174600316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 ELIZABETH STREET, 2FL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10013",
            "telephone_number": "212-227-8837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 ELIZABETH STREET, 2FL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10013",
            "telephone_number": "212-227-8837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4270 Kissena Blvd",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113553213",
            "country_code": "US",
            "telephone_number": "718-888-9838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCED EYE PHYSICIAN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2019-11-15",
        "status": "A",
        "authorized_official_last_name": "TSAI",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "212-227-8837",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "194271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02692015",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.