Eye Physicians and Surgeons of Ny, PLLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

EYE PHYSICIANS AND SURGEONS OF NY, PLLC

Practice address

2177 Victory Blvd
Staten Island, NY 10314-6603

Phone

(718) 494-9055

Fax

(718) 494-3713

NPI assigned

Aug 14, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Iris A Jordan, R.N., M.S.

Title

Office Manager

Phone

(718) 834-1976

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Mitsugu Shimmyo, M.D.

  • Ophthalmology Physician
  • New York, NY
  • NPI 1902996846
  NPD (past)

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194220800000",
    "number": "1366455339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 PIERREPONT ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112012712",
            "telephone_number": "718-834-1976",
            "fax_number": "718-855-8567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2177 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146603",
            "telephone_number": "718-494-9055",
            "fax_number": "718-494-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE PHYSICIANS AND SURGEONS OF NY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-11-05",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "IRIS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "718-834-1976",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N., M.S."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02501577",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.