Individual provider Active NPI

Vincente A Calderon, O.D.

  • Optometrist
  • East Rockaway, NY
National Provider Identifier
1457542375
Registry record updated May 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV007143-1 Issued in NY
Practice address
8 Davison PLZ
East Rockaway, NY 11518-1545
Phone
(347) 717-4117
Fax
(347) 772-3032
NPI assigned
Aug 6, 2007
Last updated
May 17, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV007143-1 NY Primary
Corneal and Contact Management Optometrist 152WC0802X TUV007143-1 NY

Addresses

Primary practice location

8 Davison PLZ
East Rockaway, NY 11518-1545

Mailing address

8 Davison PLZ
East Rockaway, NY 11518-1545
Phone (347) 717-4117

Other identifiers 1

IdentifierTypeStateIssuer
02904052MedicaidNY

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
I20100406000001 NY Practitioner - Optometry 9537295217 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
International American University at Puerto Rico - School of Optometry, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10222 Atlantic Ave
Ozone Park, NY 11416-1739
Phone (718) 846-1144

8 Davison PLZ
East Rockaway, NY 11518-1545
Phone (347) 717-4117

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV007143-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Framebar Co LLC Optometrist CurrentSince Nov 19, 2020 Accepting new patients
Aspire Health Solutions Inc Optometrist CurrentSince Feb 6, 2012 Accepting new patients
Vincente Calderon OD PC Optometrist CurrentSince Dec 1, 2010 Accepting new patients
Ejmvkk Associates Inc Optometrist CurrentSince Oct 10, 2021 Accepting new patients
Sap Optical Optometrist PastSince Oct 10, 2021 Accepting new patients

Locations

2742 E Tremont Ave
Bronx, NY 10461
Phone (347) 422-7380

2742A E Tremont Ave
Bronx, NY 10461
Phone (347) 709-3393

26001 79th Ave
Glen Oaks, NY 11004
Phone (347) 422-7380

2894 Long Beach Rd
Oceanside, NY 11572
Phone (516) 888-1038

10222 Atlantic Ave
Ozone Park, NY 11416
Phone (718) 846-1144

Organizations & group practices 7

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": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558051200000",
    "number": "1457542375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 DAVISON PLZ",
            "city": "EAST ROCKAWAY",
            "state": "NY",
            "postal_code": "115181545",
            "telephone_number": "347-717-4117",
            "fax_number": "347-772-3032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 DAVISON PLZ",
            "city": "EAST ROCKAWAY",
            "state": "NY",
            "postal_code": "115181545",
            "telephone_number": "347-717-4117",
            "fax_number": "347-772-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDERON",
        "first_name": "VINCENTE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-06",
        "last_updated": "2019-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007143-1",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NY",
            "license": "TUV007143-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02904052",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Rockaway, NY

Sources for this page

Verify at the official NPI Registry.