Justin Bazan, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

006867 Issued in NY

Practice address

682 Union St
Park Slope Eye
Brooklyn, NY 11215-1161

Phone

(347) 560-8393

Fax

(888) 850-6294

NPI assigned

May 9, 2007

Sex

Male

Sole proprietor

No

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

Accepts the Medicare-approved amount as payment in full

Group practices

Park Slope Eye, Optometric PLLCGroup PAC ID 6608921713, 2 clinicians

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.

• Park Slope Eye, Optometric PLLC

  • Optometrist
  • Brooklyn, NY
  • NPI 1750552501
  Medicare reassignment Care Compare group Authorized official

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454544000000",
    "number": "1235343559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "682 UNION ST",
            "address_2": "PARK SLOPE EYE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112151161",
            "telephone_number": "347-560-8393",
            "fax_number": "888-850-6294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "682 UNION ST",
            "address_2": "PARK SLOPE EYE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112151161",
            "telephone_number": "347-560-8393",
            "fax_number": "888-850-6294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZAN",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2016-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "006867",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8627",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bayview Optical
• Bayview Podiatry PC
• Bayville Healthcare LLC
• Vijaya Jyothshna Bayya, M.D
• Alexa Baz, LMSW
• Lud Bazar
• Tatyana Bazarova, PHARMD
• Alla Bazay, LCSWR
• Aemen Shafqat Bazaz, MD
• Adela Bazbaz Mizrahi, M.D.

• Optometrist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; 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.