Individual provider Active NPI

Shari Lynn Hausman, OD

  • Optometrist
  • New York, NY
National Provider Identifier
1295831410
Registry record updated Apr 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV005254-1 Issued in NY
Practice address
4250 Broadway
New York, NY 10033-3748
Phone
(212) 795-5640
Fax
(212) 927-6200
NPI assigned
Sep 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV005254-1 NY Primary

Addresses

Primary practice location

4250 Broadway
New York, NY 10033-3748

Mailing address

15 Eagle RDG
Montvale, NJ 07645-1357
Phone (201) 505-0151

Other identifiers 1

IdentifierTypeStateIssuer
01742736MedicaidNY

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV005254-1NYMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302220800000",
    "number": "1295831410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 EAGLE RDG",
            "city": "MONTVALE",
            "state": "NJ",
            "postal_code": "076451357",
            "telephone_number": "201-505-0151",
            "fax_number": "212-927-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100333748",
            "telephone_number": "212-795-5640",
            "fax_number": "212-927-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUSMAN",
        "first_name": "SHARI",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2011-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV005254-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01742736",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2011; 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.