Individual provider Active NPI

Yelizaveta Golubchik, O.D

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1477935443
Registry record updated Feb 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV008326-1 Issued in NY
Practice address
2313 65TH St
Brooklyn, NY 11204
Phone
(718) 975-4824
Fax
(718) 975-4823
NPI assigned
Jun 25, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV008326-1 NY Primary

Addresses

Primary practice location

2313 65TH St
Brooklyn, NY 11204

Mailing address

2313 65TH St
Brooklyn, NY 11204-4045
Phone (718) 975-4824

Other practice location 1

7516 3rd Ave
Brooklyn, NY 11209-3104
Phone (718) 836-8600

Other practice location 2

2020 86th St
Brooklyn, NY 11214-3204
Phone (718) 619-8855

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
I20151209000876 NY Practitioner - Optometry 5496056830 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008326NYMDMental Health Counselor
TUV008326-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyes on Island Inc. Optometrist CurrentSince Jun 29, 2023 Accepting new patients

Locations

150 Greaves Ln
Ste D
Staten Island, NY 10308
Phone (718) 948-1353

Organizations & group practices 2

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": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1477935443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2313 65TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112044045",
            "telephone_number": "718-975-4824",
            "fax_number": "718-975-4823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2313 65TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11204",
            "telephone_number": "718-975-4824",
            "fax_number": "718-975-4823"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7516 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112093104",
            "country_code": "US",
            "telephone_number": "718-836-8600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2020 86th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112143204",
            "country_code": "US",
            "telephone_number": "718-619-8855",
            "fax_number": "718-619-8855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLUBCHIK",
        "first_name": "YELIZAVETA",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-25",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV008326-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.