Timothy Ip, O.D

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV007418-1 Issued in NY

Practice address

6539 175TH St
Fresh Meadows, NY 11365-2137

Phone

(917) 769-9025

NPI assigned

Aug 12, 2009

Last updated

Aug 12, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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 1

Specialty

Optometry

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Raymond Fong MD, PCGroup PAC ID 5496655292, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Raymond Fong M.D., P.C.

  • Ophthalmology Physician
  • New York, NY
  • NPI 1083619274
  Medicare reassignment Care Compare group NPD
• Hollis Vision Center, Ocho, LLC

  • Optometrist
  • Queens Village, NY
  • NPI 1497905087
  Medicare reassignment NPD

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

{
    "created_epoch": "1250035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250035200000",
    "number": "1366674103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6539 175TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113652137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6539 175TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113652137",
            "telephone_number": "917-769-9025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IP",
        "first_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-12",
        "last_updated": "2009-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007418-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Infinite RX Corp (infinite pharmacy)
• Inje Physical Therapy P.C.
• Irina Inoyatova
• Integrated Rehab Professionals OT PT PLLC
• Intercity Gastroenterology P.C
• Alexandra Iskhakov, FNP
• Daniela Iskhakov, PA-C
• Olga Ismailov, MS CCC-SLP
• Elizabeth Ismailova, M.A., CCC-SLP
• Rhonda Phyllis Israel, MA, CCC-SLP

• Optometrist in Fresh Meadows, NY
• Providers in Fresh Meadows, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.