Individual provider Active NPI

Diana Simkhovich, O.D.

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1518909092
Registry record updated May 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV006899 Issued in NY
Practice address
7415 18TH Ave
Brooklyn, NY 11204-5614
Phone
(718) 232-3907
Fax
(718) 234-8188
NPI assigned
Jun 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV006899 NY Primary

Addresses

Primary practice location

7415 18TH Ave
Brooklyn, NY 11204-5614

Mailing address

7415 18TH Ave
Brooklyn, NY 11204-5614
Phone (718) 232-3907

Other identifiers 1

IdentifierTypeStateIssuer
02693947MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV006899NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Vision, Inc Optometrist Past Accepting new patients
Flatbush Optical of Starrette City PastSince Oct 1, 2008 Accepting new patients
D.S. Optometric Services PC Optometrist Past Accepting new patients

Organizations & group practices 3

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": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305763200000",
    "number": "1518909092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7415 18TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112045614",
            "telephone_number": "718-232-3907",
            "fax_number": "718-234-8188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7415 18TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112045614",
            "telephone_number": "718-232-3907",
            "fax_number": "718-234-8188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMKHOVICH",
        "first_name": "DIANA",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-11",
        "last_updated": "2011-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02693947",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.