Individual provider Active NPI

Alexander N Shlivko, OD

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1285245159
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
009186 Issued in NY
Practice address
2250 86TH St
Brooklyn, NY 11214-4139
Phone
(718) 714-1000
Fax
(718) 714-1036
NPI assigned
Aug 13, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 009186 NY Primary

Addresses

Primary practice location

2250 86TH St
Brooklyn, NY 11214-4139

Mailing address

501 Surf Ave Apt 22R
Brooklyn, NY 11224-3547
Phone (646) 204-9821

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
I20210512001020 NY Practitioner - Optometry 4880003490 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eandi Optical, IncGroup PAC ID 9133105042, 3 clinicians
Ultimate Vision LLCGroup PAC ID 8921388554, 2 clinicians
Optical Care LLCGroup PAC ID 5991086290, 3 clinicians

Practice addresses (Care Compare)

1018 C Nostrand Ave
Brooklyn, NY 11225-3509
Phone (718) 773-9391

1018 Nostrand Ave
C
Brooklyn, NY 11225-3509

1723 Ave U
Brooklyn, NY 11229-3811
Phone (718) 998-8400

2250 86TH St
Brooklyn, NY 11214-4139
Phone (718) 714-1000

3117 23Rd Ave
Astoria, NY 11105-2488
Phone (718) 626-9400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009186NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
E&I Optical, Inc Optometrist CurrentSince Jun 25, 2022 Accepting new patients
Nostrand Optical, Inc Optometrist CurrentSince Jun 25, 2022 Accepting new patients
Optical Care LLC Optometrist CurrentSince Mar 1, 2021 Accepting new patients
Ultimate Vision LLC Optometrist CurrentSince Mar 1, 2021 Accepting new patients
Oceanview Optical of Brooklyn Inc Optometrist CurrentSince Dec 1, 2021 Accepting new patients

Locations

3117 23rd Ave
Astoria, NY 11105
Phone (718) 626-9400

1018 Nostrand Ave
#C
Brooklyn, NY 11225
Phone (718) 773-9391

1723 Avenue U
Brooklyn, NY 11229
Phone (718) 998-8400

254 Brighton Beach Ave
Brooklyn, NY 11235
Phone (718) 769-9800

1018C Nostrand Ave
Brooklyn, NY 11225
Phone (718) 773-9391

2250 86th St
Brooklyn, NY 11214
Phone (718) 372-2800

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": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1285245159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 SURF AVE APT 22R",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112243547",
            "telephone_number": "646-204-9821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 86TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112144139",
            "telephone_number": "718-714-1000",
            "fax_number": "718-714-1036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHLIVKO",
        "first_name": "ALEXANDER",
        "middle_name": "N",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-13",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "009186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.