Organization Active NPI

Maximeyes Optical Inc.

  • Optometrist
  • New York, NY
National Provider Identifier
1245760719
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
005681 Issued in NY
Legal business name
MAXIMEYES OPTICAL INC.
Practice address
200 W 24TH St
New York, NY 10011-1736
Phone
(212) 929-3693
Fax
(212) 929-1620
NPI assigned
Jun 15, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Elena Rosen, ODNPI 1407810153
Title
Owner
Phone
(212) 929-3693

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 005681 NY Primary

Addresses

Primary practice location

200 W 24TH St
New York, NY 10011-1736

Mailing address

200 W 24TH St
New York, NY 10011-1736
Phone (212) 929-3693

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171113002278 NY Part B Supplier - Clinic/Group Practice 3375809031 Receives reassigned benefits from 2 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

200 W 24th St
New York, NY 10011
Phone (212) 929-3693

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1497484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1245760719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W 24TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100111736",
            "telephone_number": "212-929-3693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W 24TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100111736",
            "telephone_number": "212-929-3693",
            "fax_number": "212-929-1620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXIMEYES OPTICAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-15",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ROSEN",
        "authorized_official_first_name": "ELENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-929-3693",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "005681",
            "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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.