Organization Active NPI

Lens Lab Express of Fordham Road Inc

Doing business as Lens Lab Express

  • Optometrist
  • Bronx, NY
National Provider Identifier
1366539967
Registry record updated Dec 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
004158-1 Issued in NY
Legal business name
LENS LAB EXPRESS OF FORDHAM ROAD INC
Doing business as
Lens Lab Express
Practice address
125 E Fordham Rd
Bronx, NY 10468-5404
Phone
(718) 329-2020
Fax
(718) 561-0616
NPI assigned
Oct 6, 2006
Last updated
Dec 22, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2016

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

Authorized official

Name
Dr. Robert Magelowitz, O.D.NPI 1164517207
Title
President
Phone
(718) 329-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 004158-1 NY Primary

Addresses

Primary practice location

125 E Fordham Rd
Bronx, NY 10468-5404

Mailing address

125 E Fordham Rd
Bronx, NY 10468-5404
Phone (718) 329-2020

Other identifiers 1

IdentifierTypeStateIssuer
01874428MedicaidNY

Other names 1

  • Lens Lab Express Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170106000956 NY Part B Supplier - Clinic/Group Practice 2365723384 Receives reassigned benefits from 2 practitioners
Practice locations: Bronx, NY

National Provider Directory

National Provider Directory

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": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482364800000",
    "number": "1366539967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E FORDHAM RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104685404",
            "telephone_number": "718-329-2020",
            "fax_number": "718-561-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E FORDHAM RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104685404",
            "telephone_number": "718-329-2020",
            "fax_number": "718-561-0616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LENS LAB EXPRESS OF FORDHAM ROAD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2016-12-22",
        "status": "A",
        "authorized_official_last_name": "MAGELOWITZ",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-329-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "004158-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01874428",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lens Lab Express",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 22, 2016; 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.