Organization Active NPI

Affordable Optical of Starett City, Inc.

  • Clinic/Center
  • Brooklyn, NY
National Provider Identifier
1336305044
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
0078381 Issued in NY
Legal business name
AFFORDABLE OPTICAL OF STARETT CITY, INC.
Practice address
11122 Flatlands Ave
Brooklyn, NY 11207-8234
Phone
(718) 257-9393
NPI assigned
Aug 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2016

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

Authorized official

Name
Michael ShurNPI 1528021730
Title
President
Phone
(718) 257-9393

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 0078381 NY Primary

Addresses

Primary practice location

11122 Flatlands Ave
Brooklyn, NY 11207-8234

Mailing address

11122 Flatlands Ave
Brooklyn, NY 11207-8234
Phone (718) 257-9393

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081203000323 NY Part B Supplier - Clinic/Group Practice 9133280696 Receives reassigned benefits from 2 practitioners
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

11122 Flatlands Ave
Brooklyn, NY 11207
Phone (718) 257-9393

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1217548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471478400000",
    "number": "1336305044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11122 FLATLANDS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112078234",
            "telephone_number": "718-257-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11122 FLATLANDS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112078234",
            "telephone_number": "718-257-9393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFORDABLE OPTICAL OF STARETT CITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-01",
        "last_updated": "2016-08-18",
        "status": "A",
        "authorized_official_last_name": "SHUR",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-257-9393"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": "0078381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; 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.