Individual provider Active NPI

Sohail Sakkari

  • Optometrist
  • Queens Village, NY
National Provider Identifier
1477106201
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
008949 Issued in NY
Practice address
21543 Jamaica Ave
Queens Village, NY 11428-1736
Phone
(718) 265-0424
NPI assigned
Jul 21, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 00849 NY
Optometrist 152W00000X 008949 NY Primary

Addresses

Primary practice location

21543 Jamaica Ave
Queens Village, NY 11428-1736

Mailing address

9425 85TH Rd
Woodhaven, NY 11421-1706
Phone (347) 666-7798

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
I20220303001275 NY Practitioner - Optometry 2769876994 Reassigns benefits to 1 organization
Practice locations: Woodhaven, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00849NYMDOptometrist
008949NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lens Lab Express of Graham Avenue Inc Optometrist CurrentSince Apr 1, 2022 Accepting new patients

Locations

28 Graham Ave
Brooklyn, NY 11206
Phone (718) 486-0117

Organizations & group practices 1

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": "1563667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1477106201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9425 85TH RD",
            "city": "WOODHAVEN",
            "state": "NY",
            "postal_code": "114211706",
            "telephone_number": "347-666-7798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21543 JAMAICA AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114281736",
            "telephone_number": "718-265-0424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAKKARI",
        "first_name": "SOHAIL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-21",
        "last_updated": "2022-03-07",
        "certification_date": "2022-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "00849",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "008949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queens Village, NY

Sources for this page

Verify at the official NPI Registry.