Individual provider Active NPI

Eva Yan, O.D.

  • Optometrist
  • Bronx, NY
National Provider Identifier
1508858820
Registry record updated Apr 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV004217-1 Issued in NY
Practice address
25 Westchester SQ
Metro Optics Eyewear
Bronx, NY 10461-3545
Phone
(718) 597-6162
Fax
(718) 597-6168
NPI assigned
Aug 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV004217-1 NY Primary

Addresses

Primary practice location

25 Westchester SQ
Metro Optics Eyewear
Bronx, NY 10461-3545

Mailing address

25 Westchester SQ
Metro Optics Eyewear
Bronx, NY 10461-3545
Phone (718) 597-6162

Other identifiers 1

IdentifierTypeStateIssuer
00740390MedicaidNY

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
I20050425000652 NY Practitioner - Optometry 9931147402 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV004217-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffrey Cooper O.D., P.C. Optometrist CurrentSince Dec 26, 2023 Accepting new patients
Jeffrey Cooper O.D., P.C. Optometrist Current Accepting new patients
Metro Optics Eyewear, Inc CurrentSince Feb 8, 2007 Accepting new patients
Jeffrey Cooper OD PC CurrentSince Dec 26, 2023 Accepting new patients
Jeffrey Cooper O.D., P.C. Optometrist Past Accepting new patients
Jeffrey Cooper O.D., P.C. Optometrist Past Accepting new patients
Jeffrey Cooper O.D., P.C. Optometrist Past Accepting new patients

Locations

1038 Southern Blvd
Bronx, NY 10459
Phone (718) 328-7137

815 Hutchinson River Pkwy
Bronx, NY 10465
Phone (718) 536-2690

25 Westchester Sq
Bronx, NY 10461
Phone (718) 597-6162

815 Hutchinson River Pkwy
Ste 797
Bronx, NY 10465
Phone (718) 569-5680

1332 Metropolitan Ave
Bronx, NY 10462
Phone (718) 828-6200

161 S Central Ave
Hartsdale, NY 10530
Phone (914) 902-8845

Organizations & group practices 7

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": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366070400000",
    "number": "1508858820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 WESTCHESTER SQ",
            "address_2": "METRO OPTICS EYEWEAR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104613545",
            "telephone_number": "718-597-6162",
            "fax_number": "718-597-6168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 WESTCHESTER SQ",
            "address_2": "METRO OPTICS EYEWEAR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104613545",
            "telephone_number": "718-597-6162",
            "fax_number": "718-597-6168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAN",
        "first_name": "EVA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-22",
        "last_updated": "2013-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV004217-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00740390",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.