Individual provider Active NPI

Kristen D Tamburro, O.D,

  • Optometrist
  • New York, NY
National Provider Identifier
1366755407
Registry record updated Feb 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV 007568-1 Issued in NY
Practice address
33 W 42ND St
New York, NY 10036-8005
Phone
(212) 938-4001
NPI assigned
Jul 19, 2010
Last updated
Feb 24, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV 007568-1 NY Primary

Addresses

Primary practice location

33 W 42ND St
New York, NY 10036-8005

Mailing address

624 Hawkins Ave
Ste 1
Lake Ronkonkoma, NY 11779-2375
Phone (631) 588-5100

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20101108000172 NY Practitioner - Optometry 0547455305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Vision Associates LLPGroup PAC ID 3375432511, 5 clinicians

Practice addresses (Care Compare)

271 Smithtown Blvd
Nesconset, NY 11767-2041
Phone 6315885100204

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV 007568-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
State of New York Comptrollers Office Optometrist PastSince Aug 5, 2010 Accepting new patients
State of New York Comptrollers Office PastSince Aug 5, 2010 Accepting new patients
Red Optical Corp Optometrist PastSince Feb 1, 2017 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ktamburro@eva.eyefinity-direct.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1279497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487894400000",
    "number": "1366755407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 HAWKINS AVE",
            "address_2": "STE 1",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117792375",
            "telephone_number": "631-588-5100",
            "fax_number": "631-588-5185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 W 42ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100368005",
            "telephone_number": "212-938-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMBURRO",
        "first_name": "KRISTEN",
        "middle_name": "D",
        "credential": "O.D,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-19",
        "last_updated": "2017-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV 007568-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.