Individual provider Active NPI

Joanna Komar, OD

  • Optometrist
  • Rockaway Park, NY
National Provider Identifier
1376930099
Registry record updated Mar 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV008333 Issued in NY
Practice address
11718 Rockaway Beach Blvd
Rockaway Park, NY 11694-2018
Phone
(718) 634-5808
NPI assigned
Apr 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 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 TUV008333 NY Primary

Addresses

Primary practice location

11718 Rockaway Beach Blvd
Rockaway Park, NY 11694-2018

Mailing address

11718 Rockaway Beach Blvd
Rockaway Park, NY 11694-2018
Phone (718) 634-5808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008333NYMDMental Health Counselor
TUV008333NYMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1429574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1376930099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11718 ROCKAWAY BEACH BLVD",
            "city": "ROCKAWAY PARK",
            "state": "NY",
            "postal_code": "116942018",
            "telephone_number": "718-634-5808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11718 ROCKAWAY BEACH BLVD",
            "city": "ROCKAWAY PARK",
            "state": "NY",
            "postal_code": "116942018",
            "telephone_number": "718-634-5808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMAR",
        "first_name": "JOANNA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-21",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV008333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockaway Park, NY

Sources for this page

Verify at the official NPI Registry.