Individual provider Active NPI

Grace Ka-Yun Woo, O.D.

  • Optometrist
  • New York, NY
National Provider Identifier
1336204023
Registry record updated Jul 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
007055 Issued in NY
Practice address
205 E 64TH St
Suite 101
New York, NY 10065-6635
Phone
(212) 888-4100
Fax
(212) 888-4111
NPI assigned
Dec 25, 2006
Last updated
Jul 11, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 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 007055 NY Primary

Addresses

Primary practice location

205 E 64TH St
Suite 101
New York, NY 10065-6635

Mailing address

205 E 64TH St
Suite 101
New York, NY 10065-6635
Phone (212) 888-4100

Other identifiers 1

IdentifierTypeStateIssuer
714554275AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170412001028 NJ Practitioner - Optometry 1153228283 Reassigns benefits to 1 organization
I20170501000516 NY Practitioner - Optometry 1153228283 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sightrite Inc Optometrist CurrentSince Feb 21, 2017 Accepting new patients
Harmon Ophthalmology P.C PastSince Apr 5, 2007 Accepting new patients
Modern Eyecare of Medlock Optometrist PastSince May 17, 2005 Accepting new patients
Harmon Optical Corp. Past Accepting new patients

Locations

236 Broadway
Ste 220
Brooklyn, NY 11211

267 Broadway
Fl 2
Brooklyn, NY 11211
Phone (716) 912-5877

7144 Yellowstone Blvd
Forest Hills, NY 11375
Phone (718) 544-4300

134 Great East Neck Rd
West Babylon, NY 11704
Phone (631) 321-3850

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1167004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1336204023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 E 64TH ST",
            "address_2": "SUITE 101",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656635",
            "telephone_number": "212-888-4100",
            "fax_number": "212-888-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E 64TH ST",
            "address_2": "SUITE 101",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656635",
            "telephone_number": "212-888-4100",
            "fax_number": "212-888-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOO",
        "first_name": "GRACE",
        "middle_name": "KA-YUN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-25",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "007055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "714554275A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.