Individual provider Active NPI

Jason Compton, OD

  • Optometrist
  • New York, NY
National Provider Identifier
1205037363
Registry record updated Apr 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV006940 Issued in NY
Practice address
4738 Broadway
New York, NY 10040-1103
Phone
(646) 661-7615
Fax
(646) 661-7617
NPI assigned
May 29, 2007
Last updated
Apr 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV006940 NY Primary

Addresses

Primary practice location

4738 Broadway
New York, NY 10040-1103

Mailing address

4738 Broadway
New York, NY 10040-1103
Phone (646) 661-7615

Other practice location 1

1150 Webster Ave
Bronx, NY 10456-5205
Phone (347) 331-0717

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
I20090212000085 NY Practitioner - Optometry 9537224209 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV006940NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Compton Optometry PC CurrentSince May 1, 2015 Accepting new patients
Mark Fromer, MD PC PastSince Jan 1, 2009 Accepting new patients

Locations

1150 Webster Ave
Bronx, NY 10456
Phone (212) 567-5266

4738 Broadway
New York, NY 10040
Phone (212) 569-5330

Organizations & group practices 2

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": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587686400000",
    "number": "1205037363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4738 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100401103",
            "telephone_number": "646-661-7615",
            "fax_number": "646-661-7617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4738 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100401103",
            "telephone_number": "646-661-7615",
            "fax_number": "646-661-7617"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1150 Webster Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104565205",
            "country_code": "US",
            "telephone_number": "347-331-0717",
            "fax_number": "347-331-0718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COMPTON",
        "first_name": "JASON",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2020-04-24",
        "certification_date": "2020-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.