Individual provider Active NPI

Gabrielle Aminova, OD

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1497364095
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
009211 Issued in NY
Practice address
69 Lee Ave
Brooklyn, NY 11211-7503
Phone
(718) 522-3332
NPI assigned
Jul 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 009211 NY Primary

Addresses

Primary practice location

69 Lee Ave
Brooklyn, NY 11211-7503

Mailing address

69 Lee Ave
Brooklyn, NY 11211-7503
Phone (718) 522-3332

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
I20210719002034 NY Practitioner - Optometry 5193128809 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
200 West Optics, LLC Optometrist CurrentSince Dec 20, 2021 Accepting new patients
200 West Optics, LLC Optometrist Current Accepting new patients
Ahava Medical and Rehabilitation Center, LLC CurrentSince Jul 1, 2021 Accepting new patients
200 West Optics, LLC Optometrist CurrentSince Dec 20, 2021 Accepting new patients

Locations

16 Sumner Pl
Brooklyn, NY 11206
Phone (718) 336-9500

2555 Nostrand Ave
Brooklyn, NY 11210
Phone 7189518800108

1765 Central Park Ave
Yonkers, NY 10710
Phone (914) 961-1004

770 McLean Ave
Yonkers, NY 10704
Phone (914) 803-0500

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 4

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": "1595980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1497364095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 LEE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112117503",
            "telephone_number": "718-522-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 LEE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112117503",
            "telephone_number": "718-522-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMINOVA",
        "first_name": "GABRIELLE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-29",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "009211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.