Organization Active NPI

MD Optics LLC

  • Exclusive Provider Organization
  • Sunnyside, NY
National Provider Identifier
1386090413
Registry record updated May 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
007392 Issued in NY
Legal business name
MD OPTICS LLC
Practice address
4413 Queens Blvd
Sunnyside, NY 11104-2405
Phone
(718) 784-2477
Fax
(718) 784-2433
NPI assigned
May 7, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2016

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

Authorized official

Name
Diana Arango
Title
Office Manager
Phone
(718) 784-2477

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X 007392 NY Primary

Addresses

Primary practice location

4413 Queens Blvd
Sunnyside, NY 11104-2405

Mailing address

4413 Queens Blvd
Sunnyside, NY 11104-2405
Phone (718) 784-2477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230829001587 NY Part B Supplier - Clinic/Group Practice 1557724267 Receives reassigned benefits from 2 practitioners
Practice locations: Sunnyside, NY

National Provider Directory

National Provider Directory

Locations

4413 Queens Blvd
Sunnyside, NY 11104
Phone (718) 784-2477

Practitioners & affiliated clinicians

Practitioners 5

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": "1462579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462579200000",
    "number": "1386090413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4413 QUEENS BLVD",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "111042405",
            "telephone_number": "718-784-2477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4413 QUEENS BLVD",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "111042405",
            "telephone_number": "718-784-2477",
            "fax_number": "718-784-2433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MD OPTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-07",
        "last_updated": "2016-05-07",
        "status": "A",
        "authorized_official_last_name": "ARANGO",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "718-784-2477"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "NY",
            "license": "007392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2016; 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.