NPIMap

Organization Active NPI

Park Avenue Eyeland Inc.

  • Optometrist
  • Long Beach, NY
National Provider Identifier
1366592891
Registry record updated Nov 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T004095 Issued in NY
Legal business name
PARK AVENUE EYELAND INC.
Practice address
58 W Park Ave
Long Beach, NY 11561-2030
Phone
(516) 670-0600
NPI assigned
Jan 10, 2007
Last updated
Nov 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2008

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

Authorized official

Name
Dr. Leland Stann Barry, O.D.NPI 1386812295
Title
Optometrist
Phone
(516) 670-0600

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X T004095 NY Primary

Addresses

Primary practice location

58 W Park Ave
Long Beach, NY 11561-2030

Mailing address

186 Blackheath Rd
Lido Beach, NY 11561-4840
Phone (516) 889-0401

Other identifiers 1

IdentifierTypeStateIssuer
01059952MedicaidNY

Other names 1

  • Family Eyecare Center Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225670400000",
    "number": "1366592891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 BLACKHEATH RD",
            "city": "LIDO BEACH",
            "state": "NY",
            "postal_code": "115614840",
            "telephone_number": "516-889-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 W PARK AVE",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115612030",
            "telephone_number": "516-670-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK AVENUE EYELAND INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2008-11-03",
        "status": "A",
        "authorized_official_last_name": "BARRY",
        "authorized_official_first_name": "LELAND",
        "authorized_official_middle_name": "STANN",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "516-670-0600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "T004095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01059952",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Eyecare Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Long Beach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2008; 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.