Organization Active NPI

Canal Street Optical, Inc.

  • Optometrist
  • New York, NY
National Provider Identifier
1467550053
Registry record updated Nov 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV6116 Issued in NY
Legal business name
CANAL STREET OPTICAL, INC.
Practice address
158 Canal St
New York, NY 10013-4501
Phone
(212) 227-2978
Fax
(212) 227-2971
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2009

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

Authorized official

Name
Dr. Tony C. Mui, O.D.
Title
President / Optometrist
Phone
(212) 227-2978

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X TUV6116 NY Primary

Addresses

Primary practice location

158 Canal St
New York, NY 10013-4501

Mailing address

158 Canal St
New York, NY 10013-4501
Phone (212) 227-2978

Other identifiers 3

IdentifierTypeStateIssuer
178511POtherNYHIP
02311219MedicaidNY
43666OtherNYDAVIS VISION

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230321001748 NY Part B Supplier - Clinic/Group Practice 2163896804 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

158 Canal St
New York, NY 10013
Phone (212) 227-2978

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": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258675200000",
    "number": "1467550053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 CANAL ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134501",
            "telephone_number": "212-227-2978",
            "fax_number": "212-227-2971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 CANAL ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134501",
            "telephone_number": "212-227-2978",
            "fax_number": "212-227-2971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANAL STREET OPTICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2009-11-20",
        "status": "A",
        "authorized_official_last_name": "MUI",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT / OPTOMETRIST",
        "authorized_official_telephone_number": "212-227-2978",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV6116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "178511P",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02311219",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "43666",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2009; 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.