NPIMap

Organization Active NPI

Optical Academy Advanced MD Group LLC

  • Ophthalmology Physician
  • New York, NY
National Provider Identifier
1245672260
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
OPTICAL ACADEMY ADVANCED MD GROUP LLC
Practice address
115 W 45TH St
-Suite 504
New York, NY 10036-4005
Phone
(800) 530-2730
Fax
(631) 206-9193
NPI assigned
Jul 18, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Authorized official

Name
Ms. Abeer Ayoub
Title
Cfo
Phone
(800) 530-2730

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

115 W 45TH St
-Suite 504
New York, NY 10036-4005

Mailing address

115 W 45TH St
-Suite 504
New York, NY 10036-4005
Phone (800) 530-2730

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1374105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1245672260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W 45TH ST",
            "address_2": "-SUITE 504",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100364005",
            "telephone_number": "800-530-2730",
            "fax_number": "631-206-9193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W 45TH ST",
            "address_2": "-SUITE 504",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100364005",
            "telephone_number": "800-530-2730",
            "fax_number": "631-206-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTICAL ACADEMY ADVANCED MD GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-18",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "AYOUB",
        "authorized_official_first_name": "ABEER",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "800-530-2730",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.