Bay Ridge Eye & Retina Specialist

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

241115 Issued in NY

Legal business name

BAY RIDGE EYE & RETINA SPECIALIST

Practice address

333 86TH St
Suite 1B
Brooklyn, NY 11209-5057

Phone

(718) 630-1010

Fax

(718) 630-1020

NPI assigned

Jan 17, 2008

Organization subpart

No

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

Authorized official

Name

Samer A. Khosrof, MDNPI 1629138540

Title

President

Phone

(347) 733-5780

Specialties & licenses 1

Addresses

Other names 1

• New York Eye & Retina Specialist, P.C. Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samer A. Khosrof, M.D.

  • Ophthalmology Physician
  • Brooklyn, NY
  • NPI 1629138540
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1200528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702339200000",
    "number": "1306022652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 86TH ST",
            "address_2": "SUITE 1B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112095057",
            "telephone_number": "718-630-1010",
            "fax_number": "718-630-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 86TH ST",
            "address_2": "SUITE 1B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112095057",
            "telephone_number": "718-630-1010",
            "fax_number": "718-630-1020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "230 Central Park S Ste 1F",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100191409",
            "country_code": "US",
            "telephone_number": "212-970-1010",
            "fax_number": "646-876-1080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BAY RIDGE EYE & RETINA SPECIALIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-17",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A",
        "authorized_official_last_name": "KHOSROF",
        "authorized_official_first_name": "SAMER",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-733-5780",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "241115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New York Eye & Retina Specialist, P.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bay Ridge Dental Group, P.C.
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• Bay Ridge Dental Health PC
• Bay Ridge Endoscopy PLLC
• Bay Ridge Endoscopy Services PLLC
• Bay Ridge Family Health NP, PLLC
• Bay Ridge Family Medical Doctor P.C
• Bay Ridge Fourth Avenue Medical Associates, P. C.
• Bay Ridge Gastroenterology, PLLC
• Bay Ridge Gastroenterology, PLLC

• Ophthalmology Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.