Individual provider Active NPI

Rachel Laura Pollak, OD

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1326525841
Registry record updated Jul 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
008763 Issued in NY
Practice address
1411 Avenue N Apt B3
Brooklyn, NY 11230-5934
Phone
(718) 541-5000
NPI assigned
Jul 26, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 008763 NY Primary

Addresses

Primary practice location

1411 Avenue N Apt B3
Brooklyn, NY 11230-5934

Mailing address

1411 Avenue N Apt B3
Brooklyn, NY 11230-5934
Phone (718) 541-5000

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
I20181109000313 NY Practitioner - Optometry 0345594313 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

575 Burnside Ave
Inwood, NY 11096-1300
Phone (516) 239-8932

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eyeconic Vision Inwood LLC Optometrist CurrentSince Jan 1, 2024 Accepting new patients

Locations

575 Burnside Ave
Inwood, NY 11096
Phone (516) 239-8932

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": "1532563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532563200000",
    "number": "1326525841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 AVENUE N APT B3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305934",
            "telephone_number": "718-541-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 AVENUE N APT B3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305934",
            "telephone_number": "718-541-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLAK",
        "first_name": "RACHEL",
        "middle_name": "LAURA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-26",
        "last_updated": "2018-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "008763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.