Jym Vision Care LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

JYM VISION CARE LLC

Practice address

451 Northfield Ave
Staten Island, NY 10303

Phone

(917) 771-9899

NPI assigned

Aug 16, 2021

Organization subpart

No

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

Authorized official

Name

Jacqueline MendezNPI 1417622978

Title

Manager

Phone

(347) 670-0760

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Jacqueline Mendez

  • Optician
  • Staten Island, NY
  • NPI 1417622978
  NPD Authorized official

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630972800000",
    "number": "1235804865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "294 COLONY AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103065949",
            "telephone_number": "917-771-9899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 NORTHFIELD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10303",
            "telephone_number": "917-771-9899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JYM VISION CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-16",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A",
        "authorized_official_last_name": "MENDEZ",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "347-670-0760"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2021; 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.