Individual provider Active NPI

Charles Summer Chatman, O.D.

  • Optometrist
  • New York, NY
National Provider Identifier
1437161619
Registry record updated Feb 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3850 Issued in NY
Practice address
648 W 181St St
New York, NY 10033-3801
Phone
(212) 927-4444
Fax
(212) 568-8669
NPI assigned
Aug 13, 2006
Last updated
Feb 14, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3850 NY Primary

Addresses

Primary practice location

648 W 181St St
New York, NY 10033-3801

Mailing address

11155 77TH Ave
#1C
Forest Hills, NY 11375-7035
Phone (718) 793-3096

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050916000778 NY Practitioner - Optometry 1658304878 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Focus Medical Ny PLLCGroup PAC ID 0446799050, 4 clinicians

Practice addresses (Care Compare)

48 Graham Ave
Brooklyn, NY 11206-4002
Phone (718) 388-7400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3850NYMDOptometrist
003850NYMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne Tabachnick, OD PC Optometrist CurrentSince Oct 1, 2005 Accepting new patients
Wayne Tabachnick OD PC Optometrist Current Accepting new patients
Focus Medical Ny, PLLC Optometrist CurrentSince Jul 20, 2024 Accepting new patients
Clear View Optical Optometrist Past Accepting new patients

Locations

48 Graham Ave
Brooklyn, NY 11206
Phone (718) 388-7400

648 W 181st St
New York, NY 10033
Phone (212) 927-4444

7501 Paragon Rd
Ste 201
Dayton, OH 45459

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455408000000",
    "number": "1437161619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11155 77TH AVE",
            "address_2": "#1C",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757035",
            "telephone_number": "718-793-3096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 W 181ST ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100333801",
            "telephone_number": "212-927-4444",
            "fax_number": "212-568-8669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHATMAN",
        "first_name": "CHARLES",
        "middle_name": "SUMMER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2016-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "3850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.