Individual provider Active NPI

Sophia Serobian, OD

  • Optometrist
  • New York, NY
National Provider Identifier
1457028540
Registry record updated Feb 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
009409 Issued in NY
Practice address
60 Broad St
New York, NY 10004-2306
Phone
(212) 785-0797
NPI assigned
Aug 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 009409 NY Primary

Addresses

Primary practice location

60 Broad St
New York, NY 10004-2306

Mailing address

60 Broad St
New York, NY 10004-2306
Phone (212) 785-0797

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
I20211221002192 NY Practitioner - Optometry 7416348727 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009409NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kochman, Lebowitz & Mogil, MD'S, LLP CurrentSince Oct 1, 2021 Accepting new patients
Luxottica of America Inc. Past Accepting new patients
Luxottica of America Inc Past Accepting new patients

Locations

1301 Avenue J
Brooklyn, NY 11230
Phone (718) 645-0600

Organizations & group practices 3

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": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739664000000",
    "number": "1457028540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 BROAD ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100042306",
            "telephone_number": "212-785-0797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 BROAD ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100042306",
            "telephone_number": "212-785-0797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEROBIAN",
        "first_name": "SOPHIA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-25",
        "last_updated": "2025-02-16",
        "certification_date": "2025-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "009409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.