Individual provider Active NPI

Martin Leibowitz, O.D.

  • Optometrist
  • Holbrook, NY
National Provider Identifier
1245358753
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
003374-1 Issued in NY
Practice address
5801 Sunrise Highway
Suite 41
Holbrook, NY 11741
Phone
(631) 567-4411
NPI assigned
Mar 26, 2007
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 003374-1 NY Primary

Addresses

Primary practice location

5801 Sunrise Highway
Suite 41
Holbrook, NY 11741

Mailing address

4 2ND St
Bellport, NY 11713-2402
Phone (631) 286-6039

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
003374-1NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Sun-Vet Optical Center Corp. Optometrist Past Accepting new patients

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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245358753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 2ND ST",
            "city": "BELLPORT",
            "state": "NY",
            "postal_code": "117132402",
            "telephone_number": "631-286-6039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 SUNRISE HIGHWAY",
            "address_2": "SUITE 41",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "11741",
            "telephone_number": "631-567-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIBOWITZ",
        "first_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "003374-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holbrook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.