Danielle Polvanov, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV009442 Issued in NY

Practice address

7051 Austin St
Forest Hills, NY 11375-4729

Phone

(718) 793-1200

NPI assigned

Aug 24, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, CT2 enrollments

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 2

Specialty

Optometry

Education

State University of New York - State College Optometry, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Proeye Care LLCGroup PAC ID 6406225648, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Proeye Care LLC

  • Optometrist
  • Darien, CT
  • NPI 1922724327
  Medicare reassignment Care Compare group NPD
• Forest Hills Optometry and Ophthalmic Dispensing PLLC

  • Optometrist
  • Forest Hills, NY
  • NPI 1881270437
  NPD
• Andrielle Optical Corp

  dba American Vision Care

  • Optician
  • Forest Hills, NY
  • NPI 1447393814
  NPD (past)

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

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1518634948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6837 YELLOWSTONE BLVD APT D42",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753413",
            "telephone_number": "718-541-0852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7051 AUSTIN ST",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754729",
            "telephone_number": "718-793-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLVANOV",
        "first_name": "DANIELLE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-24",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV009442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Alexandra Polizzotto
• Judith S Pollack, LCSW
• Marina Pollack
• Maribel S Polo Bolano
• Attila J Polonyi, LCSW
• Daniel Gerard Pompa, D.D.S.
• Evan Rene Poncher, MD
• Justin C Popso, D.O.
• Jaimie Lynn Porter, OTR/L CBIS
• Rayna F Portnoy, DMD

• Optometrist in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.