Active NPI
Joseph Krol, OD
- Optometrist
- Valley Stream, NY
National Provider Identifier
1487784930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- NY 003561-2
- Practice address
- 1112 Green Acres Mall
Valley Stream, NY 11581-1536 - Phone
- (516) 825-4900
- Fax
- (516) 561-5905
- NPI assigned
- Mar 6, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | NY 003561-2 | NY | Primary |
Addresses
Primary practice location
1112 Green Acres Mall
Valley Stream, NY 11581-1536
Mailing address
1112 Green Acres Mall
Valley Stream, NY 11581-1536
Phone (516) 825-4900
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
| License | State | Type | Specialty |
|---|---|---|---|
| NY 003561-2 | NY | MD | Optometrist |
| 003561 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487784930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1112 GREEN ACRES MALL",
"city": "VALLEY STREAM",
"state": "NY",
"postal_code": "115811536",
"telephone_number": "516-825-4900",
"fax_number": "516-561-5905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1112 GREEN ACRES MALL",
"city": "VALLEY STREAM",
"state": "NY",
"postal_code": "115811536",
"telephone_number": "516-825-4900",
"fax_number": "516-561-5905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KROL",
"first_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "NY 003561-2",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Valley Stream, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.