Organization Active NPI

Pab Optical Inc

Doing business as pearle vision

  • Optician
  • Massapequa, NY
National Provider Identifier
1417086646
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
5087 Issued in NY
Legal business name
PAB OPTICAL INC
Doing business as
pearle vision
Practice address
1050 Sunrise Hwy
Massapequa, NY 11758-5325
Phone
(516) 795-7880
NPI assigned
Mar 5, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Paul Hans
Title
President
Phone
(516) 795-7880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 5087 NY Primary

Addresses

Primary practice location

1050 Sunrise Hwy
Massapequa, NY 11758-5325

Mailing address

1050 Sunrise Hwy
Massapequa, NY 11758-5325
Phone (516) 795-7880

Other names 1

  • pearle vision Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120418000701 NY Part B Supplier - Clinic/Group Practice 6406017474 Receives reassigned benefits from 2 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bohemia, NY; East Meadow, NY; Flushing, NY; Massapequa, NY; New Hyde Park, NY; Stony Brook, NY; Syosset, NY

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Dr Michael C Hans OD PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1050 Sunrise Hwy
Unit A
Massapequa, NY 11758
Phone (516) 795-7880

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417086646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 SUNRISE HWY",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585325",
            "telephone_number": "516-795-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 SUNRISE HWY",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585325",
            "telephone_number": "516-795-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAB OPTICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HANS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-795-7880",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "5087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "pearle vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Massapequa, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.