Organization Active NPI

Optical Care LLC

  • Optometrist
  • Astoria, NY
National Provider Identifier
1417499641
Registry record updated Nov 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T-003856-1 Issued in NY
Legal business name
OPTICAL CARE LLC
Practice address
3117 23Rd Ave
Astoria, NY 11105-2488
Phone
(718) 626-9400
Fax
(718) 626-9499
NPI assigned
Nov 4, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2016

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

Authorized official

Name
Yonatan Butnik
Title
Owner
Phone
(718) 626-9400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X T-003856-1 NY Primary

Addresses

Primary practice location

3117 23Rd Ave
Astoria, NY 11105-2488

Mailing address

3117 23Rd Ave
Astoria, NY 11105-2488
Phone (718) 626-9400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161228001442 NY Part B Supplier - Clinic/Group Practice 5991086290 Receives reassigned benefits from 3 practitioners
Practice locations: Astoria, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1478217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478217600000",
    "number": "1417499641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3117 23RD AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111052488",
            "telephone_number": "718-626-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3117 23RD AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111052488",
            "telephone_number": "718-626-9400",
            "fax_number": "718-626-9499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTICAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-04",
        "last_updated": "2016-11-04",
        "status": "A",
        "authorized_official_last_name": "BUTNIK",
        "authorized_official_first_name": "YONATAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-626-9400"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "T-003856-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2016; 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.