Individual provider Active NPI

Jose Ladoo

  • Optician
  • Valley Stream, NY
National Provider Identifier
1285140053
Registry record updated Dec 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
4556 Issued in NY
Practice address
77 Green Acres Rd
Valley Stream, NY 11581-1008
Phone
(516) 612-0528
Fax
(516) 887-2565
NPI assigned
Dec 15, 2017
Last updated
Dec 15, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 4556 NY Primary

Addresses

Primary practice location

77 Green Acres Rd
Valley Stream, NY 11581-1008

Mailing address

77 Green Acres Rd
Valley Stream, NY 11581-1008
Phone (516) 612-0528

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4556NYMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1513296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513296000000",
    "number": "1285140053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 GREEN ACRES RD",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811008",
            "telephone_number": "516-612-0528",
            "fax_number": "516-887-2565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 GREEN ACRES RD",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811008",
            "telephone_number": "516-612-0528",
            "fax_number": "516-887-2565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADOO",
        "first_name": "JOSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-15",
        "last_updated": "2017-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "4556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2017; 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.