Individual provider Active NPI

Pavel Manza, OD

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1245057215
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
010024 Issued in NY
Practice address
1801 Ocean Ave Apt 7C
Brooklyn, NY 11230-6235
Phone
(347) 323-0981
NPI assigned
Sep 23, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 010024 NY Primary

Addresses

Primary practice location

1801 Ocean Ave Apt 7C
Brooklyn, NY 11230-6235

Mailing address

1801 Ocean Ave Apt 7C
Brooklyn, NY 11230-6235
Phone (347) 323-0981

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
I20260528000725 NY Practitioner - Optometry 6901376292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1801 Ocean Ave Apt
7C
Brooklyn, NY 11230-6235

187 Ave U
Brooklyn, NY 11223

922 A Flatbush Ave
Brooklyn, NY 11226-4018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010024NYMDSurgical Physician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1727049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1245057215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 OCEAN AVE APT 7C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112306235",
            "telephone_number": "347-323-0981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 OCEAN AVE APT 7C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112306235",
            "telephone_number": "347-323-0981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZA",
        "first_name": "PAVEL",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-23",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "010024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.