Organization Active NPI

Leslie R Kolker OD

  • Optometrist
  • New Hyde Park, NY
National Provider Identifier
1174770317
Registry record updated Aug 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T4430 Issued in NY
Legal business name
LESLIE R KOLKER OD
Practice address
2001 Marcus Ave
Ste 286W
New Hyde Park, NY 11042-1011
Phone
(516) 328-1800
Fax
(516) 358-2329
NPI assigned
Aug 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2008

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

Authorized official

Name
Leslie KolkerNPI 1003992603
Title
Doctor
Phone
(516) 328-1800

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X T4430 NY Primary

Addresses

Primary practice location

2001 Marcus Ave
Ste 286W
New Hyde Park, NY 11042-1011

Mailing address

2001 Marcus Ave
Ste 286W
New Hyde Park, NY 11042-1011
Phone (516) 328-1800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930085679 NY DME Supplier - Physician - Optometrist 5395863989 Practice locations: Great Neck, NY

National Provider Directory

National Provider Directory

Locations

1000 Northern Blvd
Ste 310
Great Neck, NY 11021
Phone (516) 328-1800

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219104000000",
    "number": "1174770317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 MARCUS AVE",
            "address_2": "STE 286W",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421011",
            "telephone_number": "516-328-1800",
            "fax_number": "516-358-2329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 MARCUS AVE",
            "address_2": "STE 286W",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421011",
            "telephone_number": "516-328-1800",
            "fax_number": "516-358-2329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LESLIE R KOLKER OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-19",
        "last_updated": "2008-08-19",
        "status": "A",
        "authorized_official_last_name": "KOLKER",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "516-328-1800"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "T4430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; 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.