NPIMap

Organization Active NPI

Ocean Park Optical Inc.

  • Optometrist
  • Far Rockaway, NY
National Provider Identifier
1417150301
Registry record updated Jun 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T006545 Issued in NY
Legal business name
OCEAN PARK OPTICAL INC.
Practice address
1727 Seagirt Blvd
Suite 100
Far Rockaway, NY 11691-4513
Phone
(718) 471-5310
Fax
(718) 471-0840
NPI assigned
Jun 7, 2007
Last updated
Jun 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2008

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

Authorized official

Name
Dr. Jane Kutsowsky, O.D.NPI 1063518801
Title
President
Phone
(718) 471-5310

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
Optometrist 152W00000X T006545 NY Primary

Addresses

Primary practice location

1727 Seagirt Blvd
Suite 100
Far Rockaway, NY 11691-4513

Mailing address

1727 Seagirt Blvd
Suite 100
Far Rockaway, NY 11691-4513
Phone (718) 471-5310

Other identifiers 1

IdentifierTypeStateIssuer
02905493MedicaidNY

National Provider Directory

National Provider Directory

Locations

1727 Seagirt Blvd
Ste 100
Far Rockaway, NY 11691
Phone (718) 471-5310

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": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212451200000",
    "number": "1417150301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1727 SEAGIRT BLVD",
            "address_2": "SUITE 100",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116914513",
            "telephone_number": "718-471-5310",
            "fax_number": "718-471-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 SEAGIRT BLVD",
            "address_2": "SUITE 100",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116914513",
            "telephone_number": "718-471-5310",
            "fax_number": "718-471-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCEAN PARK OPTICAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2008-06-03",
        "status": "A",
        "authorized_official_last_name": "KUTSOWSKY",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-471-5310",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "T006545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02905493",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; 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.