Angela V Dussan, OD

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

007777 Issued in NY

Practice address

1016 50TH Ave
Long Island City, NY 11101-6273

Phone

(516) 792-6901

NPI assigned

Aug 5, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

New England College of Optometry, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• A Dussan Services LLC

  • Optometrist
  • Long Island City, NY
  • NPI 1831759810

  NY

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1312502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1205115474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 50TH AVE",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111016273",
            "telephone_number": "516-792-6901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 50TH AVE",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111016273",
            "telephone_number": "516-792-6901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9721 Queens Blvd",
            "address_purpose": "LOCATION",
            "city": "Rego Park",
            "state": "NY",
            "postal_code": "113742103",
            "country_code": "US",
            "telephone_number": "347-242-3884",
            "fax_number": "718-440-1895",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUSSAN",
        "first_name": "ANGELA",
        "middle_name": "V",
        "name_prefix": "Miss",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-05",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "007777",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NY",
            "license": "007777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205115474",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kamila Dumani
• Courtney Dunn, LMSW
• Shirley Duperois
• Wilfrid Durandys Jr.
• Nathalie Duroseau
• Paola Lily Dvoretskaya
• Faustina Dwamena
• Marissa Dwarica
• Tyler Dymond, PT, DPT, CSCS
• Elvina Dzhemilova, R.N.

• All providers in Long Island City, NY
• Corneal and Contact Management Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.