Active NPI
Shari Lynn Hausman, OD
- Optometrist
- New York, NY
National Provider Identifier
1295831410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TUV005254-1
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01742736 | Medicaid | NY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| TUV005254-1 | NY | MD | Optometrist |
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.