NPIMap

Organization Active NPI

Victory Vision Center LLC

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1386033868
Registry record updated Jan 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
008816 Issued in NY
Legal business name
VICTORY VISION CENTER LLC
Practice address
565 Atlantic Ave
Brooklyn, NY 11217-1913
Phone
(718) 915-0791
Fax
(718) 622-5404
NPI assigned
Jan 21, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2015

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

Authorized official

Name
Viktor Kolesnyk
Title
Vice President
Phone
(718) 915-0791

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 008816 NY Primary
Contact Lens FitterGroup: 193200000X MULTI-SPECIALTY GROUP 156FC0801X 008816 NY
Eyewear Supplier 332H00000X 008716 NY

Addresses

Primary practice location

565 Atlantic Ave
Brooklyn, NY 11217-1913

Mailing address

565 Atlantic Ave
Brooklyn, NY 11217-1913
Phone (718) 915-0791

Other identifiers 1

IdentifierTypeStateIssuer
02857014MedicaidNY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1421798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421798400000",
    "number": "1386033868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "565 ATLANTIC AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112171913",
            "telephone_number": "718-915-0791",
            "fax_number": "718-622-5404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 ATLANTIC AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112171913",
            "telephone_number": "718-915-0791",
            "fax_number": "718-622-5404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY VISION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-21",
        "last_updated": "2015-01-21",
        "status": "A",
        "authorized_official_last_name": "KOLESNYK",
        "authorized_official_first_name": "VIKTOR",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "718-915-0791"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "008816",
            "primary": true
        },
        {
            "code": "156FC0801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Contact Lens Fitter",
            "state": "NY",
            "license": "008816",
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NY",
            "license": "008716",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02857014",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.