Individual provider Active NPI

Kenneth J. Horowitz, O.D.

  • Optometrist
  • Staten Island, NY
National Provider Identifier
1366426504
Registry record updated Jan 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
003008-1 Issued in NY
Practice address
927 Willowbrook Rd
Staten Island, NY 10314-4274
Phone
(718) 982-8790
Fax
(718) 982-9366
NPI assigned
Dec 1, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 003008-1 NY Primary

Addresses

Primary practice location

927 Willowbrook Rd
Staten Island, NY 10314-4274

Mailing address

927 Willowbrook Rd
Staten Island, NY 10314-4274
Phone (718) 982-8790

Other identifiers 1

IdentifierTypeStateIssuer
00339551MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20031110000164 NY Practitioner - Optometry 9133032832 Reassigns benefits to 2 organizations
Practice locations: Elmhurst, NY; Flushing, NY; Staten Island, NY
I20120507000134 NJ Practitioner - Optometry 9133032832 Practice locations: East Brunswick, NJ; Edison, NJ; South Plainfield, NJ

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2555 Nostrand Ave
Brooklyn, NY 11210-4730

927 Willowbrook Rd
Staten Island, NY 10314-4274
Phone (718) 948-9235

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
003008-1NYMDMental Health Counselor
003008NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Ahava Medical and Rehabilitation Center, LLC CurrentSince May 1, 2010 Accepting new patients
University Physicians of Brooklyn, Inc. CurrentSince Jan 1, 2003 Accepting new patients
University Physicians of Brooklyn, Inc. CurrentSince Jan 1, 2003 Accepting new patients

Locations

450 Clarkson Ave
Ste J
Brooklyn, NY 11203
Phone (718) 270-1714

450 Clarkson Ave
#58
Brooklyn, NY 11203
Phone (718) 270-1714

450 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 270-1603

2555 Nostrand Ave
Brooklyn, NY 11210
Phone 7189518800108

Organizations & group practices 3

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": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768780800000",
    "number": "1366426504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 WILLOWBROOK RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144274",
            "telephone_number": "718-982-8790",
            "fax_number": "718-982-9366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 WILLOWBROOK RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144274",
            "telephone_number": "718-982-8790",
            "fax_number": "718-982-9366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOROWITZ",
        "first_name": "KENNETH",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "003008-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00339551",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.