Individual provider Active NPI

Anthony Pilavas, MD

  • Ophthalmology Physician
  • Astoria, NY
National Provider Identifier
1417065657
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
157990 Issued in NY
Practice address
2509 31St Ave
Astoria, NY 11106-3620
Phone
(718) 204-5100
Fax
(718) 204-2580
NPI assigned
Aug 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 157990 NY Primary

Addresses

Primary practice location

2509 31St Ave
Astoria, NY 11106-3620

Mailing address

2509 31St Ave
Astoria, NY 11106-3620
Phone (718) 204-5100

Other identifiers 1

IdentifierTypeStateIssuer
00850151MedicaidNY

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110120000245 NY Practitioner - Ophthalmology 6800075011 Practice locations: Brooklyn, NY; New York, NY; Astoria, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
157990NYMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417065657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2509 31ST AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111063620",
            "telephone_number": "718-204-5100",
            "fax_number": "718-204-2580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2509 31ST AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111063620",
            "telephone_number": "718-204-5100",
            "fax_number": "718-204-2580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PILAVAS",
        "first_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "157990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00850151",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

Verify at the official NPI Registry.