Organization Active NPI

Vip Optical, Inc.

  • Optician
  • Brooklyn, NY
National Provider Identifier
1548496797
Registry record updated Aug 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
008486 Issued in NY
Legal business name
VIP OPTICAL, INC.
Practice address
1916 86TH St
Brooklyn, NY 11214-3104
Phone
(718) 621-1624
NPI assigned
Jun 2, 2009
Last updated
Aug 26, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2011

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

Authorized official

Name
Lenny Temiryayev, O.D.NPI 1710055397
Title
Owner
Phone
(718) 621-1624

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X 008486 NY Primary

Addresses

Primary practice location

1916 86TH St
Brooklyn, NY 11214-3104

Mailing address

1916 86TH St
Brooklyn, NY 11214-3104
Phone (718) 621-1624

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100428000219 NY Part B Supplier - Clinic/Group Practice 4981731783 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314316800000",
    "number": "1548496797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1916 86TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112143104",
            "telephone_number": "718-621-1624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1916 86TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112143104",
            "telephone_number": "718-621-1624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIP OPTICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-02",
        "last_updated": "2011-08-26",
        "status": "A",
        "authorized_official_last_name": "TEMIRYAYEV",
        "authorized_official_first_name": "LENNY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-621-1624",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "008486",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 26, 2011; 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.