Individual provider Active NPI

Eksupar Tongsri, O.D.

  • Optometrist
  • New York, NY
National Provider Identifier
1437383635
Registry record updated Jul 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV006827-1 Issued in NY
Practice address
415 Grand Street
E1505
New York, NY 10002
Phone
(917) 664-4446
NPI assigned
May 4, 2009
Last updated
Jul 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV006827-1 NY Primary

Addresses

Primary practice location

415 Grand Street
E1505
New York, NY 10002

Mailing address

1594 Flatbush Ave
Brooklyn, NY 11210-3030
Phone (917) 664-4446

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
I20091021000472 NY Practitioner - Optometry 7517004773 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comfort Vision Inc.Group PAC ID 8820135031, 3 clinicians

Practice addresses (Care Compare)

1594 Flatbush Ave
Brooklyn, NY 11210-3030
Phone (718) 434-0539

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV006827-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Comfort Vision Inc. CurrentSince Nov 21, 2010 Accepting new patients

Locations

1594 Flatbush Ave
Brooklyn, NY 11210
Phone (718) 343-0539

Organizations & group practices 1

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": "1241395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562284800000",
    "number": "1437383635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1594 FLATBUSH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112103030",
            "telephone_number": "917-664-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 GRAND STREET",
            "address_2": "E1505",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10002",
            "telephone_number": "917-664-4446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TONGSRI",
        "first_name": "EKSUPAR",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-04",
        "last_updated": "2019-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006827-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.