Active NPI
Ilana Bronfman, OD
- Optometrist
- Brooklyn, NY
National Provider Identifier
1447070131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- ORT011030-01
- Practice address
- 519 5TH Ave
Brooklyn, NY 11215-7372 - Phone
- (718) 768-1020
- Fax
- (718) 768-1050
- NPI assigned
- Oct 16, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | ORT011030-01 | NY | Primary |
Addresses
Primary practice location
519 5TH Ave
Brooklyn, NY 11215-7372
Mailing address
2654 E 26TH St Apt 3a
Brooklyn, NY 11235-6047
Phone (646) 667-9333
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- State University of New York - State College Optometry, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
519 5TH Ave
Brooklyn, NY 11215-7372
Phone (718) 768-1020
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ORT011030-01 | NY | MD | Optometrist |
| 011030 | NY | MD | Physician Assistant |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729036800000",
"number": "1447070131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2654 E 26TH ST APT 3A",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112356047",
"telephone_number": "646-667-9333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "519 5TH AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112157372",
"telephone_number": "718-768-1020",
"fax_number": "718-768-1050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRONFMAN",
"first_name": "ILANA",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-16",
"last_updated": "2024-10-16",
"certification_date": "2024-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "ORT011030-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.