Eyevista Optometry of 86, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV007407-1 Issued in NY

Legal business name

EYEVISTA OPTOMETRY OF 86, LLC

Practice address

1883 86TH St
Brooklyn, NY 11214-3108

Phone

(718) 256-2020

Fax

(718) 256-2027

NPI assigned

May 6, 2013

Organization subpart

No

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

Authorized official

Name

Jackie Wai Kit Chan, ODNPI 1366672925

Title

Owner

Phone

(718) 256-2020

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jackie Wai Kit Chan, O.D.

  • Optometrist
  • Brooklyn, NY
  • NPI 1366672925
  Medicare reassignment Care Compare group NPD Authorized official
• Janice Y Tan

  • Optometrist
  • Flushing, NY
  • NPI 1053935064
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1367798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554854400000",
    "number": "1376988253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1883 86TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112143108",
            "telephone_number": "718-256-2020",
            "fax_number": "718-256-2027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1883 86TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112143108",
            "telephone_number": "718-256-2020",
            "fax_number": "718-256-2027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYEVISTA OPTOMETRY OF 86, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-06",
        "last_updated": "2019-04-10",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_middle_name": "WAI KIT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-256-2020",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007407-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Allande Eyma, LPN
• Rebecca Eyre, LMHC, LPC
• Katherine E Eytcheson, LMT
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• 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 Apr 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.