Individual provider Active NPI

Natalya Malakova, O.D.

  • Optometrist
  • Forest Hills, NY
National Provider Identifier
1497795983
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
VUT006389 Issued in NY
Practice address
6405 Yellowstone Blvd
Suite CF-103
Forest Hills, NY 11375-1530
Phone
(718) 830-0201
Fax
(718) 830-0206
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X VUT006389 NY Primary

Addresses

Primary practice location

6405 Yellowstone Blvd
Suite CF-103
Forest Hills, NY 11375-1530

Mailing address

6405 Yellowstone Blvd
Suite CF-103
Forest Hills, NY 11375-1530
Phone (917) 680-0404

Other identifiers 1

IdentifierTypeStateIssuer
02162229MedicaidNY

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
I20040621001381 NY Practitioner - Optometry 9931199502 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

64 -05 Yellowstone Blvd
CF 103
Forest Hills, NY 11375-1530

6405 Yellowstone Blvd
Forest Hills, NY 11375-1530
Phone (718) 830-0201

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
VUT006389NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Vision, Inc Optometrist Past Accepting new patients

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1497795983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6405 YELLOWSTONE BLVD",
            "address_2": "SUITE CF-103",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751530",
            "telephone_number": "917-680-0404",
            "fax_number": "718-830-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6405 YELLOWSTONE BLVD",
            "address_2": "SUITE CF-103",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751530",
            "telephone_number": "718-830-0201",
            "fax_number": "718-830-0206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALAKOVA",
        "first_name": "NATALYA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "VUT006389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02162229",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.