NPIMap

Organization Active NPI

Astoria Vision Center Inc

  • Optometrist
  • Astoria, NY
National Provider Identifier
1356544266
Registry record updated Feb 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T004992-1 Issued in NY
Legal business name
ASTORIA VISION CENTER INC
Practice address
3620 Broadway
Astoria, NY 11106-1046
Phone
(718) 204-2007
Fax
(718) 204-2008
NPI assigned
Jun 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2013

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

Authorized official

Name
Mr. Isaias LopeNPI 1114100021
Title
Owner Optician
Phone
(718) 204-2007

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X T004992-1 NY Primary
OpticianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 156FX1800X 006945-1 NY

Addresses

Primary practice location

3620 Broadway
Astoria, NY 11106-1046

Mailing address

36-20 Broadway Ave
Astoria, NY 11106-1046
Phone (718) 204-2007

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130417000068 NY Part B Supplier - Clinic/Group Practice 9234375387 Receives reassigned benefits from 13 practitioners
Practice locations: Astoria, NY

National Provider Directory

National Provider Directory

Locations

3620 Broadway
Astoria, NY 11106
Phone (718) 204-2007

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360108800000",
    "number": "1356544266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36-20 BROADWAY AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111061046",
            "telephone_number": "718-204-2007",
            "fax_number": "718-204-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 BROADWAY",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111061046",
            "telephone_number": "718-204-2007",
            "fax_number": "718-204-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASTORIA VISION CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2013-02-06",
        "status": "A",
        "authorized_official_last_name": "LOPE",
        "authorized_official_first_name": "ISAIAS",
        "authorized_official_title_or_position": "OWNER OPTICIAN",
        "authorized_official_telephone_number": "718-204-2007",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "T004992-1",
            "primary": true
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "006945-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2013; 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.