Individual provider Active NPI

Kevin Jon Leung, O.D.

  • Optometrist
  • Bayside, NY
National Provider Identifier
1356014377
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV009387-01 Issued in NY
Practice address
3925 Bell Blvd
Bayside, NY 11361-2060
Phone
(718) 279-2020
NPI assigned
Jul 26, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV009387-01 NY Primary

Addresses

Primary practice location

3925 Bell Blvd
Bayside, NY 11361-2060

Mailing address

1636 Jasmine Ave
New Hyde Park, NY 11040-4339
Phone (516) 849-3733

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
I20211115002304 NY Practitioner - Optometry 9234528118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye and I Eyecare LLCGroup PAC ID 0749523108, 3 clinicians

Practice addresses (Care Compare)

3925 Bell Blvd
Bayside, NY 11361-2060
Phone (718) 279-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV009387-01NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye & I Eyecare LLC Optometrist CurrentSince Nov 1, 2021 Accepting new patients
Eye & I Eyecare LLC Optometrist CurrentSince Nov 1, 2021 Accepting new patients

Locations

3925 Bell Blvd
Bayside, NY 11361
Phone (718) 279-2020

805 Northern Blvd
Ste 2
Great Neck, NY 11021
Phone (253) 228-9990

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": "1627257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1356014377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1636 JASMINE AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110404339",
            "telephone_number": "516-849-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 BELL BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113612060",
            "telephone_number": "718-279-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEUNG",
        "first_name": "KEVIN",
        "middle_name": "JON",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-26",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV009387-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

Verify at the official NPI Registry.