Individual provider Active NPI

Kim Staiman Rothstein, O.D.

  • Optometrist
  • Forest Hills, NY
National Provider Identifier
1306803879
Registry record updated Apr 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
VUT005855 Issued in NY
Practice address
11045 Queens Blvd
Ste Aa
Forest Hills, NY 11375
Phone
(718) 261-2727
Fax
(718) 261-5302
NPI assigned
Apr 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X VUT005855 NY Primary

Addresses

Primary practice location

11045 Queens Blvd
Ste Aa
Forest Hills, NY 11375

Mailing address

11045 Queens Blvd
Ste Aa
Forest Hills, NY 11375
Phone (718) 261-2727

Other identifiers 1

IdentifierTypeStateIssuer
00244528MedicaidNY

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
I20100629000648 NY Practitioner - Optometry 1456446293 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Robert Rothstein MD PCGroup PAC ID 6800838798, 3 clinicians

Practice addresses (Care Compare)

11045 Queens Blvd
Suite Aa
Forest Hills, NY 11375-7440
Phone (718) 261-2727

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
95.97
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
VUT005855NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
State of New York Comptrollers Office Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: krothstein@eyenamicsny.direct.eyemdemr.com

Organizations & group practices 2

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": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492819200000",
    "number": "1306803879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11045 QUEENS BLVD",
            "address_2": "STE AA",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "718-261-2727",
            "fax_number": "718-261-5302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11045 QUEENS BLVD",
            "address_2": "STE AA",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "718-261-2727",
            "fax_number": "718-261-5302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHSTEIN",
        "first_name": "KIM",
        "middle_name": "STAIMAN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-28",
        "last_updated": "2017-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "VUT005855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00244528",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.