Grigoriy Shimonov, O.D

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV006831 Issued in NY

Practice address

15614 Crossbay Blvd
Howard Beach, NY 11414-2745

Phone

(718) 738-2020

NPI assigned

Aug 2, 2005

Last updated

Jan 19, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

State University of New York - State College Optometry, 2004

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Jamierose Eyeware Inc

  • Optometrist
  • Howard Beach, NY
  • NPI 1568548568
  Medicare reassignment NPD
• Laser and Microsurgery, PC

  • Ophthalmology Physician
  • Brooklyn, NY
  • NPI 1871508440
  NPD (past)
• New York Eye Associates, LLC

  • Ophthalmology Physician
  • Brooklyn, NY
  • NPI 1770598369
  NPD (past)
• Omega Optical Inc

  • Optician
  • Rego Park, NY
  • NPI 1336360767
  NPD (past)
• Steinway Eye Care Centers, Inc.

  • Optometrist
  • Astoria, NY
  • NPI 1316415151
  NPD (past)

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1215938139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15614 CROSSBAY BLVD",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114142745",
            "telephone_number": "718-738-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15614 CROSSBAY BLVD",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114142745",
            "telephone_number": "718-738-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMONOV",
        "first_name": "GRIGORIY",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006831",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NY",
            "license": "TUV006831",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ayda Shahi, MSSW
• Avram M Shapiro, DPM
• Shaina N Sharifian
• Yana Sheftalovich, FNP
• Thomas Shim, MD
• Shoukri Tewfik MD PC
• Alex Rabindra Singh
• Deborah Ann Smith, MA CCC-SLP
• Lori Smith, M.S.
• Merante Smith

• Optometrist in Howard Beach, NY
• Providers in Howard Beach, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; 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.