Susan Ataly Antigua Gonzalez, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

011210 Issued in NY

Practice address

102 Graham Ave
Brooklyn, NY 11206-3334

Phone

(718) 690-2177

NPI assigned

Jul 17, 2025

Last updated

Jul 17, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

State University of New York - State College Optometry, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Eye Care Center, Inc

  • Ophthalmology Physician
  • Brooklyn, NY
  • NPI 1225538457

  Optometrist

  NPD

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

{
    "created_epoch": "1752710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1376435859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 ASHFORD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112072722",
            "telephone_number": "646-406-2016",
            "fax_number": "646-406-2016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 GRAHAM AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112063334",
            "telephone_number": "718-690-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTIGUA GONZALEZ",
        "first_name": "SUSAN",
        "middle_name": "ATALY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-17",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "011210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Anthony
• Nicole Beaumont Anthony
• Viktoriya L Anthony
• Popi Anthoulis, PHARM.D
• Fran Antigone, LCSW
• Rose S Antilus, MD
• Bertha Serwaa Antobre
• Lindy Antoine-Crute
• Azalia Antoine, MBBS
• Bernadette L. Antoine

• Optometrist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2025; 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.