Individual provider Active NPI

Joel N Kestenbaum, OD

  • Optometrist
  • Plainview, NY
National Provider Identifier
1447249933
Registry record updated Sep 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
VUT003883 Issued in NY
Practice address
431 S Oyster Bay Rd
Plainview, NY 11803-3313
Phone
(516) 931-6330
Fax
(516) 931-6352
NPI assigned
Oct 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X VUT003883 NY Primary

Addresses

Primary practice location

431 S Oyster Bay Rd
Plainview, NY 11803-3313

Mailing address

431 S Oyster Bay Rd
Plainview, NY 11803-3313
Phone (516) 931-6330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
VUT003883NYMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190764800000",
    "number": "1447249933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 S OYSTER BAY RD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118033313",
            "telephone_number": "516-931-6330",
            "fax_number": "516-931-6352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 S OYSTER BAY RD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118033313",
            "telephone_number": "516-931-6330",
            "fax_number": "516-931-6352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESTENBAUM",
        "first_name": "JOEL",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2007-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "VUT003883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainview, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2007; 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.