David Klibanoff

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODTG476 Issued in RI

Practice address

121 Broad St
Pawtucket, RI 02860-2053

Phone

(401) 723-3400

Fax

(401) 727-2326

NPI assigned

Mar 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in RI

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Klibanoff Eye Associates, LTD

  • Corneal and Contact Management Optometrist
  • Pawtucket, RI
  • NPI 1467508556
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1142121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1275501421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 BROAD ST",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028602053",
            "telephone_number": "401-723-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 BROAD ST",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028602053",
            "telephone_number": "401-723-3400",
            "fax_number": "401-727-2326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLIBANOFF",
        "first_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-12",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "RI",
            "license": "ODTG476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shadi Kiriaki, M.D.
• Erika Klein, MD
• Klibanoff Eye Associates LTD
• Klibanoff Eye Associates, LTD
• Benjamin D Klibanoff, OD
• Mona Klibanoff, O.D.
• Victoria Ann Knight, PARAMEDIC
• Knoah Ventures LLC
• Donald Paul Koch, LICSW
• John Kokolski, M.ED, MBA

• Optometrist in Pawtucket, RI
• Providers in Pawtucket, RI by specialty
• Optometrist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.