Individual provider Active NPI

Joanna Sarantakos, OPTOMETRIST

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1265454797
Registry record updated Feb 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T004937 Issued in NY
Practice address
1594 Flatbush Ave
Brooklyn, NY 11210-3030
Phone
(718) 434-0539
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T004937 NY Primary

Addresses

Primary practice location

1594 Flatbush Ave
Brooklyn, NY 11210-3030

Mailing address

1014 66TH St
Brooklyn, NY 11219-5905

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
I20091021000051 NY Practitioner - Optometry 4880731090 Reassigns benefits to 1 organization
Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6819 18TH Ave
Brooklyn, NY 11204-4416
Phone (718) 236-6090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T004937NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Indelicato Opticians Inc. CurrentSince Oct 15, 2022 Accepting new patients

Locations

6819 18th Ave
Brooklyn, NY 11204
Phone (718) 236-6090

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202169600000",
    "number": "1265454797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 66TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112195905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1594 FLATBUSH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112103030",
            "telephone_number": "718-434-0539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARANTAKOS",
        "first_name": "JOANNA",
        "credential": "OPTOMETRIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2008-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "T004937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.