Premium Laser Ophthalmology LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

179425 Issued in NY

Legal business name

PREMIUM LASER OPHTHALMOLOGY LLC

Practice address

125 W 79TH St
First Floor
New York, NY 10024-6454

Phone

(212) 580-8881

NPI assigned

Feb 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mark L Hornfeld, DONPI 1467428573

Title

Owner

Phone

(212) 590-8881

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/imedicware_premiumlaseroph

Practitioners 8

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

• Mark Louis Hornfeld, DO

  • Ophthalmology Physician
  • New York, NY
  • NPI 1467428573
  Medicare reassignment NPD Authorized official
• Raphael A Castillo, MD

  • Ophthalmology Physician
  • New York, NY
  • NPI 1770664294
  Medicare reassignment NPD
• Marina Greyman, DPM

  • Podiatrist
  • Forest Hills, NY
  • NPI 1174577795
  NPD (past)
• Ron Hornfeld, DMD

  • Dentist
  • New York, NY
  • NPI 1275825473
  NPD (past)
• Catherine Cano Seria, PT

  • Physical Therapist
  • New York, NY
  • NPI 1194050633
  NPD (past)
• Lawrence Shapiro, P.T

  • Specialist
  • New York, NY
  • NPI 1750403697
  NPD (past)
• Samuel T Wong, M.D.

  • Ophthalmology Physician
  • Jamestown, NY
  • NPI 1881888642
  NPD (past)
• Shikha Goenka

  • Physical Therapist
  • Union City, NJ
  • NPI 1033529516
  NPD (past)

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581897600000",
    "number": "1407995863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 WEST 79TH STREET",
            "address_2": "FIRST FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10024",
            "telephone_number": "212-580-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 W 79TH ST",
            "address_2": "FIRST FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100246454",
            "telephone_number": "212-580-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM LASER OPHTHALMOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A",
        "authorized_official_last_name": "HORNFELD",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-590-8881",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "179425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premise Health of New York Medical, P.C
• Premise Health of New York Medical, P.C
• Premise Health of New York Medical, P.C
• Premise Health of New York Medical, P.C
• Premise Health of New York Medical, P.C
• Premium Therapy Speech Services P.C.
• Akiff Premjee
• Nana A Prempeh-Keteku, NURSE PRACTITIONER
• Anna Prendella, MSW
• Edith Marie Prendergast, NP

• Ophthalmology Physician in New York, NY
• Providers in New York, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2020; 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.