Organization Active NPI

Bronx Vista Optique, Inc

  • Optometrist
  • Bronx, NY
National Provider Identifier
1356831762
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
BRONX VISTA OPTIQUE, INC
Practice address
3870 White Plains Rd
Bronx, NY 10467-5190
Phone
(718) 652-5801
NPI assigned
May 11, 2018
Last updated
Jan 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Authorized official

Name
Dr. Rostislav Ryvkin, ODNPI 1699757526
Title
Partner
Phone
(917) 207-0658

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
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

3870 White Plains Rd
Bronx, NY 10467-5190

Mailing address

3870 White Plains Rd
Bronx, NY 10467-5190

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181213001508 NY Part B Supplier - Clinic/Group Practice 4981949344 Receives reassigned benefits from 2 practitioners
Practice locations: Bronx, NY

National Provider Directory

National Provider Directory

Locations

3870 White Plains Rd
Bronx, NY 10467
Phone (718) 652-5801

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1525996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674518400000",
    "number": "1356831762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3870 WHITE PLAINS RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104675190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3870 WHITE PLAINS RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104675190",
            "telephone_number": "718-652-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRONX VISTA OPTIQUE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-11",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A",
        "authorized_official_last_name": "RYVKIN",
        "authorized_official_first_name": "ROSTISLAV",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "917-207-0658",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; 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.