Individual provider Active NPI

Alan Richard Minkoff, O.D.

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1487718631
Registry record updated Nov 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV003471-1 Issued in NY
Practice address
6806 Bay Pkwy
Brooklyn, NY 11204-5524
Phone
(718) 236-4352
Fax
(718) 837-0783
NPI assigned
Dec 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV003471-1 NY Primary

Addresses

Primary practice location

6806 Bay Pkwy
Brooklyn, NY 11204-5524

Mailing address

6806 Bay Parkway
Brooklyn, NY 11204-5524
Phone (718) 236-4352

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV003471-1NYMDOptometrist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227571200000",
    "number": "1487718631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6806 BAY PARKWAY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112045524",
            "telephone_number": "718-236-4352",
            "fax_number": "718-837-0783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6806 BAY PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112045524",
            "telephone_number": "718-236-4352",
            "fax_number": "718-837-0783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINKOFF",
        "first_name": "ALAN",
        "middle_name": "RICHARD",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2008-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV003471-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.