Individual provider Active NPI

Carolyn Ko Busby, O.D.

  • Corneal and Contact Management Optometrist
  • New York, NY
National Provider Identifier
1497874697
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
T 0064-01 Issued in NY
Practice address
506 Malcolm X Blvd
Ron Brown Building, 4TH FL
New York, NY 10037-1802
Phone
(212) 939-8210
Fax
(212) 939-3843
NPI assigned
Mar 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X T 0064-01 NY Primary

Addresses

Primary practice location

506 Malcolm X Blvd
Ron Brown Building, 4TH FL
New York, NY 10037-1802

Mailing address

97 E Church St
Bergenfield, NJ 07621-1827
Phone (201) 244-5488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20180823000099 NJ Practitioner - Optometry 3173888039 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
Group practices
Eye Centers of America LLCGroup PAC ID 7315125184, 127 clinicians

Practice addresses (Care Compare)

1255 Broad St
Suite 104
Bloomfield, NJ 07003-3061
Phone (973) 707-5632

89 N Maple Ave
Suite 5
Ridgewood, NJ 07450-3235
Phone (201) 445-1991

Hospital & facility affiliations

  • Harlem Hospital Center Hospital, New York, NY, CCN 330240

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as group
Quality
96.31
Promoting interoperability
100
Improvement activities
40
Cost
73.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T 0064-01NYMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Centers of America, LLC CurrentSince Nov 8, 2021 Accepting new patients

Locations

210 S Washington Ave
Bergenfield, NJ 07621
Phone (201) 771-7444

1255 Broad St
Ste 104
Bloomfield, NJ 07003
Phone (973) 707-5632

5 S Island Ave
Ramsey, NJ 07446
Phone (201) 327-5110

Interoperability endpoints

  • Direct secure messaging: cbusby673374@nychhc.direct-ci.com

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497874697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 E CHURCH ST",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076211827",
            "telephone_number": "201-244-5488",
            "fax_number": "212-939-3843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 MALCOLM X BLVD",
            "address_2": "RON BROWN BUILDING, 4TH FL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100371802",
            "telephone_number": "212-939-8210",
            "fax_number": "212-939-3843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSBY",
        "first_name": "CAROLYN",
        "middle_name": "KO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NY",
            "license": "T 0064-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.