Organization Active NPI

William C Boozan MD PC

  • Ophthalmology Physician
  • New Hyde Park, NY
National Provider Identifier
1215068176
Registry record updated Sep 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
WILLIAM C BOOZAN MD PC
Practice address
1915 New Hyde Park Rd
New Hyde Park, NY 11040-2028
Phone
(516) 775-6640
Fax
(516) 775-7069
NPI assigned
Mar 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2016

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

Authorized official

Name
Dr. William C Boozan, MD
Title
President
Phone
(516) 775-6640

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1915 New Hyde Park Rd
New Hyde Park, NY 11040-2028

Mailing address

1915 New Hyde Park Rd
New Hyde Park, NY 11040-2028
Phone (516) 775-6640

Other identifiers 1

IdentifierTypeStateIssuer
01841978MedicaidNY

National Provider Directory

National Provider Directory

Locations

111 7th St
Unit 103
Garden City, NY 11530
Phone (516) 747-3349

247 3rd Ave
Rm 202
New York, NY 10010
Phone (212) 353-8805

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473724800000",
    "number": "1215068176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 NEW HYDE PARK RD",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110402028",
            "telephone_number": "516-775-6640",
            "fax_number": "516-775-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 NEW HYDE PARK RD",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110402028",
            "telephone_number": "516-775-6640",
            "fax_number": "516-775-7069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM C BOOZAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2016-09-13",
        "status": "A",
        "authorized_official_last_name": "BOOZAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-775-6640",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01841978",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.