Individual provider Active NPI

Victoria Kravchenko, O.D.

  • Optometrist
  • Waldwick, NJ
National Provider Identifier
1205148244
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV007588 Issued in NY
Practice address
16 E Prospect St
Waldwick, NJ 07463-2008
Phone
(917) 690-4947
NPI assigned
Jul 7, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV007588 NY Primary

Addresses

Primary practice location

16 E Prospect St
Waldwick, NJ 07463-2008

Mailing address

2933 Broadway
New York, NY 10025-7801
Phone (212) 662-0400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120416000268 NY Practitioner - Optometry 0345401527 Reassigns benefits to 1 organization
I20230201000189 NJ Practitioner - Optometry 0345401527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

16 E Prospect St
Waldwick, NJ 07463-2008
Phone (201) 559-3977

2933 Broadway
New York, NY 10025-7801
Phone (212) 662-0400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV007588NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Fuzaro Vision Group Inc CurrentSince Mar 1, 2025 Accepting new patients
A2Z Eyecare PC Optometrist CurrentSince Jan 1, 2023 Accepting new patients
Krishna Pharmacy Inc PastSince Oct 30, 2022 Accepting new patients
Milan Optique Inc Optometrist Past Accepting new patients
National Eyecare of Yonkers Past Accepting new patients

Locations

16 E Prospect St
Waldwick, NJ 07463
Phone (201) 445-1100

2933 Broadway
New York, NY 10025
Phone (212) 662-0400

Organizations & group practices 5

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": "1278460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1205148244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2933 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100257801",
            "telephone_number": "212-662-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 E PROSPECT ST",
            "city": "WALDWICK",
            "state": "NJ",
            "postal_code": "074632008",
            "telephone_number": "917-690-4947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAVCHENKO",
        "first_name": "VICTORIA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-07",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldwick, NJ

Sources for this page

Verify at the official NPI Registry.