Individual provider Active NPI

Sabina Oboukova, OD

  • Optometrist
  • New York, NY
National Provider Identifier
1407343494
Registry record updated Aug 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
008865 Issued in NY
Practice address
33 W 42ND St
New York, NY 10036
Phone
(561) 929-9660
NPI assigned
Apr 16, 2018
Last updated
Aug 15, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 008865 NY Primary

Addresses

Primary practice location

33 W 42ND St
New York, NY 10036

Mailing address

600 S Dixie Hwy Apt 830
West Palm Beach, FL 33401-5860
Phone (561) 929-9660

Other practice location 1

760 Broadway
Brooklyn, NY 11206-5317
Phone (561) 929-9660

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180920000131 NY Practitioner - Optometry 2466703129 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harlem Vistasite Eye Care IncGroup PAC ID 2860733011, 3 clinicians
Smart Medical PLLCGroup PAC ID 0648400028, 12 clinicians

Practice addresses (Care Compare)

2204 Frederick Douglass Blvd
New York, NY 10026-1172
Phone (646) 895-9000

2613 E 16TH St
FL 2
Brooklyn, NY 11235-3805
Phone (718) 265-9900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008865NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bronx Vision Group Inc Optometrist CurrentSince Jun 14, 2024 Accepting new patients
State of New York Comptrollers Office Optometrist CurrentSince Aug 7, 2018 Accepting new patients
State of New York Comptrollers Office CurrentSince Aug 7, 2018 Accepting new patients
Smart Medical PLLC CurrentSince Oct 25, 2023 Accepting new patients
Harlem Vistasite Eye Care Inc Optometrist CurrentSince Nov 11, 2025 Accepting new patients

Locations

665 Pelham Pkwy N
Apt 102
Bronx, NY 10467
Phone (347) 324-4207

2613 E 16th St
Fl 2
Brooklyn, NY 11235
Phone (718) 265-9900

2204 Frederick Douglass Blvd
New York, NY 10026
Phone (646) 895-9000

33 W 42nd St
New York, NY 10036
Phone (212) 780-4930

33 W 42nd St
Fl 10
New York, NY 10036
Phone (212) 780-4930

University Eye Ctr
New York, NY 10087

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1523836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1407343494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S DIXIE HWY APT 830",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334015860",
            "telephone_number": "561-929-9660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 W 42ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10036",
            "telephone_number": "561-929-9660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "760 Broadway",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112065317",
            "country_code": "US",
            "telephone_number": "561-929-9660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OBOUKOVA",
        "first_name": "SABINA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-16",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "008865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.