Individual provider Active NPI

Phoebe Ahn, OD

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1376375303
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
011061 Issued in NY
Practice address
398 Bridge St
Brooklyn, NY 11201-5210
Phone
(718) 865-8159
NPI assigned
Aug 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Optometrist 152WP0200X 011061 NY
Optometrist 152W00000X 011061 NY Primary

Addresses

Primary practice location

398 Bridge St
Brooklyn, NY 11201-5210

Mailing address

1763 2ND Ave Apt 40K
New York, NY 10128-5372

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
I20241009000770 NY Practitioner - Optometry 7315478732 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011061NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ny Ophthalmology and Medical Associates PLLC CurrentSince Oct 1, 2024 Accepting new patients
Eric S Dessner MD PC CurrentSince Dec 23, 2025 Accepting new patients

Locations

632 Flatbush Ave
Brooklyn, NY 11225
Phone (718) 865-8159

81 Willoughby St
Fl 4
Brooklyn, NY 11201
Phone (718) 522-3399

398 Bridge St
Brooklyn, NY 11201
Phone (718) 865-8159

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1376375303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1763 2ND AVE APT 40K",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101285372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "398 BRIDGE ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015210",
            "telephone_number": "718-865-8159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHN",
        "first_name": "PHOEBE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "NY",
            "license": "011061",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "011061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.