Organization Active NPI

Roosevelt Optometry Associates PLLC

  • Optometrist
  • Jackson Heights, NY
National Provider Identifier
1356116396
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
ROOSEVELT OPTOMETRY ASSOCIATES PLLC
Doing business as
Roosevelt Family Eye Care
Practice address
9109 Roosevelt Ave
Jackson Heights, NY 11372-7995
Phone
(516) 343-4003
NPI assigned
Nov 20, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Authorized official

Name
Dr. Sanaz Ooriel, ODNPI 1508140575
Title
Authorized Official/President/OD
Phone
(718) 269-1198

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

9109 Roosevelt Ave
Jackson Heights, NY 11372-7995

Mailing address

9109 Roosevelt Ave
Jackson Heights, NY 11372-7995

Other names 1

  • Roosevelt Family Eye Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240730002143 NY Part B Supplier - Clinic/Group Practice 3274070032 Receives reassigned benefits from 1 practitioner
Practice locations: Jackson Heights, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1700438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1356116396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9109 ROOSEVELT AVE",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9109 ROOSEVELT AVE",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727995",
            "telephone_number": "516-343-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOSEVELT OPTOMETRY ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-20",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-08",
        "status": "A",
        "authorized_official_last_name": "OORIEL",
        "authorized_official_first_name": "SANAZ",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL/PRESIDENT/OD",
        "authorized_official_telephone_number": "718-269-1198",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roosevelt Family Eye Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Roosevelt Family Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.