NPIMap

Organization Active NPI

My Optician Inc.

  • Optician
  • Brooklyn, NY
National Provider Identifier
1275501694
Registry record updated Jun 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
007320 Issued in NY
Legal business name
MY OPTICIAN INC.
Practice address
9516 Church Ave
Brooklyn, NY 11212-2434
Phone
(718) 495-8801
NPI assigned
Mar 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2010

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

Authorized official

Name
Marat ShlimovNPI 1013985431
Title
Owner/Optician
Phone
(718) 495-8801

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
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X 007320 NY Primary

Addresses

Primary practice location

9516 Church Ave
Brooklyn, NY 11212-2434

Mailing address

9516 Church Ave
Brooklyn, NY 11212-2434

Other identifiers 1

IdentifierTypeStateIssuer
02104543MedicaidNY

National Provider Directory

National Provider Directory

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": "1141948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276819200000",
    "number": "1275501694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9516 CHURCH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112122434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9516 CHURCH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112122434",
            "telephone_number": "718-495-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY OPTICIAN INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-10",
        "last_updated": "2010-06-18",
        "status": "A",
        "authorized_official_last_name": "SHLIMOV",
        "authorized_official_first_name": "MARAT",
        "authorized_official_title_or_position": "OWNER/OPTICIAN",
        "authorized_official_telephone_number": "718-495-8801"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "007320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02104543",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2010; 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.