NPIMap

Organization Active NPI

My Optician Nyc Corp

  • Optician
  • Bronx, NY
National Provider Identifier
1417092313
Registry record updated Oct 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
007320 Issued in NY
Legal business name
MY OPTICIAN NYC CORP
Practice address
5227 Broadway
Bronx, NY 10463-7636
Phone
(212) 693-1111
Fax
(212) 693-1114
NPI assigned
Feb 20, 2007
Last updated
Oct 25, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2013

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

Authorized official

Name
Marat ShlimovNPI 1013985431
Title
Optician
Phone
(212) 693-1111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 007320 NY Primary

Addresses

Primary practice location

5227 Broadway
Bronx, NY 10463-7636

Mailing address

5227 Broadway
Bronx, NY 10463
Phone (212) 693-1111

Other identifiers 1

IdentifierTypeStateIssuer
02622966MedicaidNY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382659200000",
    "number": "1417092313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5227 BROADWAY",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10463",
            "telephone_number": "212-693-1111",
            "fax_number": "212-693-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5227 BROADWAY",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104637636",
            "telephone_number": "212-693-1111",
            "fax_number": "212-693-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY OPTICIAN NYC CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2013-10-25",
        "status": "A",
        "authorized_official_last_name": "SHLIMOV",
        "authorized_official_first_name": "MARAT",
        "authorized_official_title_or_position": "OPTICIAN",
        "authorized_official_telephone_number": "212-693-1111"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "007320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02622966",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.