Individual provider Active NPI

Omawathi Debidat

  • Optician
  • Valley Stream, NY
National Provider Identifier
1346485976
Registry record updated Dec 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
007341-1 Issued in NY
Practice address
1152 Green Acres Mall
Valley Stream, NY 11581-1538
Phone
(516) 568-2020
NPI assigned
Dec 11, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 007341-1 NY Primary

Addresses

Primary practice location

1152 Green Acres Mall
Valley Stream, NY 11581-1538

Mailing address

1152 Green Acres Mall
Valley Stream, NY 11581-1538
Phone (516) 568-2020

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

LicenseStateTypeSpecialty
007341-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
TNT Optics, Inc Optician Past Accepting new patients
I Can See Optical Past Accepting new patients

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": "1228953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228953600000",
    "number": "1346485976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1152 GREEN ACRES MALL",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811538",
            "telephone_number": "516-568-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1152 GREEN ACRES MALL",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811538",
            "telephone_number": "516-568-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBIDAT",
        "first_name": "OMAWATHI",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-11",
        "last_updated": "2008-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "007341-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.