Active NPI
Suresh Sanpaul, OPTICIAN
- Optician
- Jamaica, NY
National Provider Identifier
1336577493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 005810
- Practice address
- 18116 Hillside Ave
Jamaica, NY 11432-4852 - Phone
- (718) 297-2997
- Fax
- (188) 809-8497
- NPI assigned
- Oct 28, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 005810 | NY | Primary |
Addresses
Primary practice location
18116 Hillside Ave
Jamaica, NY 11432-4852
Mailing address
9065 180TH St PH
Jamaica, NY 11432-5612
Phone (718) 297-2997
Other practice location 1
9065 180th St
Jamaica, NY 11432-5612
Phone (718) 297-2997
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03978205 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005810 | NY | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Digital Optiks LLC | Optician | Current | Accepting new patients |
| Digital Optiks LLC | Optician | Current | Accepting new patients |
Locations
18116 Hillside Ave
Jamaica, NY 11432
Phone (718) 297-2997
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": "1382918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722211200000",
"number": "1336577493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9065 180TH ST PH",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114325612",
"telephone_number": "718-297-2997",
"fax_number": "718-880-9849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18116 HILLSIDE AVE",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114324852",
"telephone_number": "718-297-2997",
"fax_number": "188-809-8497"
}
],
"practiceLocations": [
{
"address_1": "9065 180th St",
"address_purpose": "LOCATION",
"city": "Jamaica",
"state": "NY",
"postal_code": "114325612",
"country_code": "US",
"telephone_number": "718-297-2997",
"fax_number": "718-880-9849",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SANPAUL",
"first_name": "SURESH",
"name_prefix": "Mr.",
"credential": "OPTICIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-10-28",
"last_updated": "2024-07-29",
"certification_date": "2024-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NY",
"license": "005810",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03978205",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.