Individual provider Active NPI

Stavros Perlegis, O.D.

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1558330050
Registry record updated Oct 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
005451 Issued in NY
Practice address
7411 5TH Ave
Brooklyn, NY 11209-2713
Phone
(718) 921-4827
Fax
(718) 921-4827
NPI assigned
Mar 16, 2006
Last updated
Oct 4, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 005451 NY Primary

Addresses

Primary practice location

7411 5TH Ave
Brooklyn, NY 11209-2713

Mailing address

7411 5TH Ave
Brooklyn, NY 11209-2713
Phone (718) 921-4827

Other identifiers 1

IdentifierTypeStateIssuer
01630111MedicaidNY

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
I20101104000310 NY Practitioner - Optometry 4789796673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1993
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7411 5TH Ave
Suite a
Brooklyn, NY 11209-2713
Phone (718) 921-4827

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Oasis Vision Center Optometrist CurrentSince Oct 1, 1984 Accepting new patients

Locations

7411 5th Ave
Ste A
Brooklyn, NY 11209
Phone (718) 921-4827

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191456000000",
    "number": "1558330050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7411 5TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112092713",
            "telephone_number": "718-921-4827",
            "fax_number": "718-921-4827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7411 5TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112092713",
            "telephone_number": "718-921-4827",
            "fax_number": "718-921-4827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERLEGIS",
        "first_name": "STAVROS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2007-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "005451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01630111",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.