Individual provider Active NPI

Carly Sheftell Stevens, OD

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1487334140
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
009865 Issued in NY
Practice address
395 Jay St
Brooklyn, NY 11201-5164
Phone
(718) 887-2660
Fax
(718) 679-9706
NPI assigned
Jul 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 009865 NY Primary

Addresses

Primary practice location

395 Jay St
Brooklyn, NY 11201-5164

Mailing address

395 Jay St
Brooklyn, NY 11201-5164
Phone (718) 887-2660

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
I20231207000417 NY Practitioner - Optometry 4082063722 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009865NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Optometry Care PC Optometrist CurrentSince Oct 28, 2023 Accepting new patients

Locations

385 E 149th St
Bronx, NY 10455
Phone (347) 385-2633

395 Jay St
Brooklyn, NY 11201
Phone (718) 887-2660

250 Skillman St
Ste 204
Brooklyn, NY 11205
Phone (513) 341-7173

1422 Saint Nicholas Ave
New York, NY 10033

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": "1689638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1487334140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 JAY ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015164",
            "telephone_number": "718-887-2660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 JAY ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015164",
            "telephone_number": "718-887-2660",
            "fax_number": "718-679-9706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "CARLY",
        "middle_name": "SHEFTELL",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-18",
        "last_updated": "2025-05-15",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "009865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.