Organization Active NPI

Sunset Eyecare PC

  • Optometrist
  • North Babylon, NY
National Provider Identifier
1467103499
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
SUNSET EYECARE PC
Practice address
1148 Deer Park Ave
North Babylon, NY 11703-3102
Phone
(631) 242-0808
Fax
(631) 272-3683
NPI assigned
Jan 11, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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

Authorized official

Name
Dr. Peter Fong, ODNPI 1023352689
Title
Owner
Phone
(330) 708-4184

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1148 Deer Park Ave
North Babylon, NY 11703-3102

Mailing address

1148 Deer Park Ave
North Babylon, NY 11703-3102
Phone (631) 242-0808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220121000119 NY Part B Supplier - Clinic/Group Practice 2163814385 Receives reassigned benefits from 2 practitioners
Practice locations: North Babylon, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641859200000",
    "number": "1467103499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1148 DEER PARK AVE",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "117033102",
            "telephone_number": "631-242-0808",
            "fax_number": "631-272-3683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1148 DEER PARK AVE",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "117033102",
            "telephone_number": "631-242-0808",
            "fax_number": "631-272-3683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSET EYECARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-11",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A",
        "authorized_official_last_name": "FONG",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-708-4184",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Babylon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.