Individual provider Active NPI

Sophia Visanji, OD

  • Optometrist
  • New York, NY
National Provider Identifier
1275948150
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
008195 Issued in NY
Practice address
312 Bleecker St
New York, NY 10014-3437
Phone
(212) 989-7060
NPI assigned
Jun 30, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 008195 NY Primary

Addresses

Primary practice location

312 Bleecker St
New York, NY 10014-3437

Mailing address

632 Broadway
New York, NY 10012-2614
Phone (617) 835-9404

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
I20150526001354 NY Practitioner - Optometry 3173843505 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008195NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Myles Zakheim Optometrist CurrentSince Sep 15, 2023 Accepting new patients
Kuona Optometry PLLC Optometrist CurrentSince Sep 3, 2025 Accepting new patients
See Inc Optometrist Past Accepting new patients
Modern Physician Services PC PastSince Mar 1, 2015 Accepting new patients

Locations

416 N Fairfax Ave
Los Angeles, CA 90036
Phone (323) 866-2020

632 Broadway
Ste Z
New York, NY 10012
Phone (212) 432-5847

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CHFABD

Organizations & group practices 5

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": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1275948150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100122614",
            "telephone_number": "617-835-9404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 BLEECKER ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100143437",
            "telephone_number": "212-989-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISANJI",
        "first_name": "SOPHIA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-30",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "008195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.