Individual provider Active NPI

Ezra M Cohen, O.D.

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1487655965
Registry record updated Dec 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV003854-1 Issued in NY
Practice address
372 Avenue U
Brooklyn, NY 11223-4018
Phone
(718) 946-5060
Fax
(718) 946-5161
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV003854-1 NY Primary

Addresses

Primary practice location

372 Avenue U
Brooklyn, NY 11223-4018

Mailing address

372 Avenue U
Brooklyn, NY 11223-4018
Phone (718) 946-5060

Other identifiers 1

IdentifierTypeStateIssuer
00503255MedicaidNY

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
I20061220000176 NY Practitioner - Optometry 0840299863 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Century Medical and Dental Center IncGroup PAC ID 8729070669, 107 clinicians

Practice addresses (Care Compare)

260 Ave X
Brooklyn, NY 11223-5940
Phone (718) 336-8855

341 Kings Hwy
Brooklyn, NY 11223-1443
Phone (718) 946-5060

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV003854-1NYMDOptometrist
003854NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Azrikan & Ezra Cohen Optometrist CurrentSince Dec 1, 1986 Accepting new patients
E & a Medical Solutions LLC CurrentSince Aug 1, 2018 Accepting new patients
Century Medical & Dental Center Inc CurrentSince Oct 1, 2012 Accepting new patients
Ezra E Cohen OD, PLLC Optometrist CurrentSince Oct 7, 2015 Accepting new patients
N. S. So Island Diag GRP Past Accepting new patients
Suny Downstate Medical Center PastSince Oct 1, 2012 Accepting new patients
Eye Appeal Inc. Past Accepting new patients

Locations

341 Kings Hwy
Frnt
Brooklyn, NY 11223

260 Avenue X
Brooklyn, NY 11223
Phone (718) 336-8855

1523 Mermaid Ave
Brooklyn, NY 11224
Phone (718) 372-2611

341 Kings Hwy
Brooklyn, NY 11223
Phone (718) 946-5060

6860 Austin St
Ste 10
Forest Hills, NY 11375
Phone (718) 896-4100

51 E 125th St
Frnt 2
New York, NY 10035
Phone (646) 585-1515

Organizations & group practices 7

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197504000000",
    "number": "1487655965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "372 AVENUE U",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112234018",
            "telephone_number": "718-946-5060",
            "fax_number": "718-946-5161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "372 AVENUE U",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112234018",
            "telephone_number": "718-946-5060",
            "fax_number": "718-946-5161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "EZRA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2007-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV003854-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00503255",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.