Individual provider Active NPI

Vaishali Nigam

  • Optometrist
  • Valley Stream, NY
National Provider Identifier
1497985154
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV007429-1 Issued in NY
Practice address
77 Green Acres Rd
Valley Stream, NY 11581-1008
Phone
(516) 612-0528
Fax
(516) 887-2565
NPI assigned
Jul 15, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV007429-1 NY Primary

Addresses

Primary practice location

77 Green Acres Rd
Valley Stream, NY 11581-1008

Mailing address

45 Shelbourne LN
New Hyde Park, NY 11040-1038
Phone (516) 776-8751

Other practice location 1

6000 Brush Hollow Rd
Westbury, NY 11590-1702
Phone (516) 750-8349

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
I20111019000005 NY Practitioner - Optometry 5395917249 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV007429-1NYMDOptometrist

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.

NPI Registry JSON

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

{
    "created_epoch": "1247616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1497985154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 SHELBOURNE LN",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401038",
            "telephone_number": "516-776-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 GREEN ACRES RD",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811008",
            "telephone_number": "516-612-0528",
            "fax_number": "516-887-2565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6000 Brush Hollow Rd",
            "address_purpose": "LOCATION",
            "city": "Westbury",
            "state": "NY",
            "postal_code": "115901702",
            "country_code": "US",
            "telephone_number": "516-750-8349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIGAM",
        "first_name": "VAISHALI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-15",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007429-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

Verify at the official NPI Registry.