Individual provider Active NPI

Lily Chin, OD

  • Optometrist
  • New York, NY
National Provider Identifier
1497069009
Registry record updated Jun 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV007595 Issued in NY
Practice address
128 Mott St
New York, NY 10013-5540
Phone
(212) 732-0073
Fax
(212) 732-0191
NPI assigned
Aug 6, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV007595 NY Primary

Addresses

Primary practice location

128 Mott St
New York, NY 10013-5540

Mailing address

128 Mott St
New York, NY 10013-5540
Phone (212) 732-0073

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
I20120430000246 NY Practitioner - Optometry 5890957393 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ophthalmic Consultants of Long IslandGroup PAC ID 8022909076, 107 clinicians

Practice addresses (Care Compare)

450 Endo Blvd
Garden City, NY 11530-6723
Phone (516) 832-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV007595NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ophthalmic Consultants of Long Island CurrentSince Jul 7, 2022 Accepting new patients
Ophthalmic Consultants of Long Island PastSince Jul 7, 2022 Accepting new patients

Locations

4 Technology Dr
Ste 150
East Setauket, NY 11733
Phone (631) 941-1400

711 Stewart Ave
Ste 160
Garden City, NY 11530
Phone (516) 500-4200

825 E Gate Blvd
Ste 111
Garden City, NY 11530
Phone (516) 804-5200

450 Endo Blvd
Garden City South, NY 11530
Phone (516) 832-8000

2000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1777

135 Crossways Park Dr
Ste 101
Woodbury, NY 11797
Phone (516) 822-3911

Interoperability endpoints

  • Direct secure messaging: lily.chin.p1@direct.ocli.nextgenshare.com

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": "1281052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402963200000",
    "number": "1497069009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 MOTT ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100135540",
            "telephone_number": "212-732-0073",
            "fax_number": "212-732-0191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 MOTT ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100135540",
            "telephone_number": "212-732-0073",
            "fax_number": "212-732-0191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIN",
        "first_name": "LILY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-06",
        "last_updated": "2014-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.