Individual provider Active NPI

Laurel A Freedman, O.D.

  • Optometrist
  • Dix Hills, NY
National Provider Identifier
1184934275
Registry record updated Aug 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV004400-1 Issued in NY
Practice address
699A Old Country Rd
Dix Hills, NY 11746-4613
Phone
(631) 271-3520
Fax
(631) 271-3706
NPI assigned
Oct 7, 2010
Last updated
Aug 1, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV004400-1 NY Primary

Addresses

Primary practice location

699A Old Country Rd
Dix Hills, NY 11746-4613

Mailing address

699A Old Country Rd
Dix Hills, NY 11746-4613
Phone (631) 271-3520

Other identifiers 1

IdentifierTypeStateIssuer
03367737MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
TUV004400-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sunshine Optical, Inc. Optometrist Past 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": "1286409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438387200000",
    "number": "1184934275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "699A OLD COUNTRY RD",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117464613",
            "telephone_number": "631-271-3520",
            "fax_number": "631-271-3706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699A OLD COUNTRY RD",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117464613",
            "telephone_number": "631-271-3520",
            "fax_number": "631-271-3706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEDMAN",
        "first_name": "LAUREL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-07",
        "last_updated": "2015-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV004400-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03367737",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dix Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.