Individual provider Active NPI

Mark G. Shafiroff, OD

  • Optometrist
  • West Hempstead, NY
National Provider Identifier
1245306570
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T003320-1 Issued in NY
Practice address
500 Hempstead Tpke
West Hempstead, NY 11552-1125
Phone
(516) 489-2262
Fax
(516) 539-0296
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T003320-1 NY Primary

Addresses

Primary practice location

500 Hempstead Tpke
West Hempstead, NY 11552-1125

Mailing address

500 Hempstead Tpke
West Hempstead, NY 11552-1125
Phone (516) 489-2262

Other identifiers 1

IdentifierTypeStateIssuer
02320818MedicaidNY

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
I20090327000464 NY Practitioner - Optometry 3678630175 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T003320-1NYMDOptometrist
003320NYMDAthletic Trainer

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245306570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 HEMPSTEAD TPKE",
            "city": "WEST HEMPSTEAD",
            "state": "NY",
            "postal_code": "115521125",
            "telephone_number": "516-489-2262",
            "fax_number": "516-539-0296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HEMPSTEAD TPKE",
            "city": "WEST HEMPSTEAD",
            "state": "NY",
            "postal_code": "115521125",
            "telephone_number": "516-489-2262",
            "fax_number": "516-539-0296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFIROFF",
        "first_name": "MARK",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "T003320-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02320818",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hempstead, NY

Sources for this page

Verify at the official NPI Registry.