Individual provider Active NPI

Jessica Moskovich, OD

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1194563825
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
009991 Issued in NY
Practice address
2020 86TH St
Brooklyn, NY 11214-3204
Phone
(718) 619-8855
NPI assigned
Jul 17, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 009991 NY Primary

Addresses

Primary practice location

2020 86TH St
Brooklyn, NY 11214-3204

Mailing address

2684 E 66TH St
Brooklyn, NY 11234-6805
Phone (718) 210-7162

Other practice location 1

2313 65th St
Brooklyn, NY 11204-4045
Phone (718) 975-4824

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
I20250626003597 NY Practitioner - Optometry 2567975287 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arthur Bukhatetsky OD PLLCGroup PAC ID 0042336331, 6 clinicians

Practice addresses (Care Compare)

519 5TH Ave
Brooklyn, NY 11215-7372
Phone (718) 768-1020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009991NYMDMedical Physician Assistant

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1721174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1194563825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2684 E 66TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112346805",
            "telephone_number": "718-210-7162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 86TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112143204",
            "telephone_number": "718-619-8855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2313 65th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112044045",
            "country_code": "US",
            "telephone_number": "718-975-4824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSKOVICH",
        "first_name": "JESSICA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-17",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "009991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.