Individual provider Active NPI

Vladimir Poley, O.D.

  • Optometrist
  • Glen Oaks, NY
National Provider Identifier
1285644088
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV006252 Issued in NY
Practice address
25923 Union Tpke
Glen Oaks, NY 11004-1248
Phone
(718) 347-7470
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV006252 NY Primary

Addresses

Primary practice location

25923 Union Tpke
Glen Oaks, NY 11004-1248

Mailing address

25923 Union Tpke
Glen Oaks, NY 11004-1248

Other identifiers 1

IdentifierTypeStateIssuer
02134027MedicaidNY

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
I20071127000054 NY Practitioner - Optometry 2860580925 Reassigns benefits to 2 organizations
Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

25913 Union Tpke
Floral Park, NY 11004-1248
Phone (718) 347-7470

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV006252NYMDOptometrist
006252NYMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Glen Oaks Family Vision Corp Optometrist CurrentSince Apr 29, 2002 Accepting new patients
Bayside Vision Corp Optometrist CurrentSince Aug 6, 2023 Accepting new patients
Bayside Family Vision Corp Optometrist CurrentSince Sep 1, 2014 Accepting new patients
Bensonhurst Family Vision Corp. Optometrist CurrentSince Jan 4, 1999 Accepting new patients
Bensonhurst Family Vision Corp. Past Accepting new patients
Liberty Optical Inc Optometrist PastSince Feb 8, 2008 Accepting new patients
Rona Appel MD PC Past Accepting new patients

Locations

2142 86th St
Brooklyn, NY 11214
Phone (718) 372-5144

4101 Bell Blvd
Flushing, NY 11361
Phone (718) 428-6700

25913 Union Tpke
Glen Oaks, NY 11004
Phone (718) 347-7470

10425 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 850-6300

Organizations & group practices 7

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285644088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25923 UNION TPKE",
            "city": "GLEN OAKS",
            "state": "NY",
            "postal_code": "110041248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25923 UNION TPKE",
            "city": "GLEN OAKS",
            "state": "NY",
            "postal_code": "110041248",
            "telephone_number": "718-347-7470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLEY",
        "first_name": "VLADIMIR",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02134027",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Oaks, NY

Sources for this page

Verify at the official NPI Registry.