Organization Active NPI

Optical on Main Inc

  • Optician
  • New Rochelle, NY
National Provider Identifier
1528095593
Registry record updated May 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
004106 Issued in NY
Legal business name
OPTICAL ON MAIN INC
Practice address
499 Main St
New Rochelle, NY 10801-6461
Phone
(914) 235-5222
Fax
(914) 235-5225
NPI assigned
Jun 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2008

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

Authorized official

Name
Mr. Jessica Rodriguez
Title
Billing Manager
Phone
(914) 235-5222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X 004106 NY Primary

Addresses

Primary practice location

499 Main St
New Rochelle, NY 10801-6461

Mailing address

499 Main St
New Rochelle, NY 10801-6461
Phone (914) 235-5222

Other names 1

  • DBA Envisage Vision Plus Style Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040315000026 NY Part B Supplier - Clinic/Group Practice 4880583178 Receives reassigned benefits from 2 practitioners
Practice locations: New Rochelle, NY

National Provider Directory

National Provider Directory

Locations

499 Main St
New Rochelle, NY 10801
Phone (914) 235-5222

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211846400000",
    "number": "1528095593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 MAIN ST",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108016461",
            "telephone_number": "914-235-5222",
            "fax_number": "914-235-5225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 MAIN ST",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108016461",
            "telephone_number": "914-235-5222",
            "fax_number": "914-235-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTICAL ON MAIN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-27",
        "last_updated": "2008-05-27",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "914-235-5222",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "004106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA Envisage Vision Plus Style",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New Rochelle, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.