Individual provider Active NPI

Pezhman Hourizadeh, O.D.

  • Optometrist
  • Corona, NY
National Provider Identifier
1205851706
Registry record updated Mar 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV0070451 Issued in NY
Practice address
10306 Roosevelt Ave
Corona, NY 11368-2330
Phone
(718) 424-1333
NPI assigned
Jul 13, 2006
Last updated
Mar 24, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV0070451 NY Primary

Addresses

Primary practice location

10306 Roosevelt Ave
Corona, NY 11368-2330

Mailing address

10306 Roosevelt Ave
Corona, NY 11368-2330
Phone (718) 424-1333

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
I20061018000262 NY Practitioner - Optometry 1951307784 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Corona Optometry PCGroup PAC ID 9335224054, 4 clinicians

Practice addresses (Care Compare)

6939 Austin St
Forest Hills, NY 11375-4243
Phone (718) 261-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV0070451NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Corona Optometry, PC Optometrist CurrentSince Nov 15, 2007 Accepting new patients
Kew Gardens Optometry, P.C. Optometrist CurrentSince Sep 15, 2008 Accepting new patients
East West Opticians Past Accepting new patients
Corona Optometry PC Optometrist Past Accepting new patients

Locations

2248 31st St
Astoria, NY 11105
Phone (718) 267-1333

10304 Roosevelt Ave
Corona, NY 11368
Phone (718) 424-1333

10306 Roosevelt Ave
Corona, NY 11368
Phone (718) 424-1333

3781 Junction Blvd
Corona, NY 11368
Phone (718) 446-1333

7259 Kissena Blvd
Flushing, NY 11367
Phone (718) 263-2020

6939 Austin St
Forest Hills, NY 11375
Phone (718) 261-6000

Organizations & group practices 4

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458777600000",
    "number": "1205851706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10306 ROOSEVELT AVE",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113682330",
            "telephone_number": "718-424-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10306 ROOSEVELT AVE",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113682330",
            "telephone_number": "718-424-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOURIZADEH",
        "first_name": "PEZHMAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2016-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV0070451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, NY

Sources for this page

Verify at the official NPI Registry.