Active NPI
Dara Anissa Shalom, OD
- Optometrist
- New York, NY
National Provider Identifier
1558419804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- T006573
- Practice address
- 345 E 37TH St
301
New York, NY 10016-3256 - Phone
- (800) 984-2020
- Fax
- (203) 869-0333
- NPI assigned
- Jan 5, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | T006573 | NY | Primary |
Addresses
Primary practice location
345 E 37TH St
301
New York, NY 10016-3256
Mailing address
41 W Putnam Ave
Greenwich, CT 06830-5300
Phone (203) 869-2255
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| T006573 | Other | NY | STATE LICENSE |
Other names 1
- Dara Anissa Greenberg
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
| License | State | Type | Specialty |
|---|---|---|---|
| T006573 | NY | MD | Optometrist |
| 006573 | NY | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sharpest Vision Refractive Surgery PC | Optometrist | Past | Accepting new patients |
| New Jersey Refractive Professional Corporation | Optometrist | Past | Accepting new patients |
| Greenwich Eye Center | 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.
-
dba Diamond Vision
- Ophthalmology Physician
- New York, NY
- NPI 1487898193
Optometrist
-
dba Diamond Vision
- Ophthalmology Physician
- Paramus, NJ
- NPI 1336346618
Optometrist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1558419804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41 W PUTNAM AVE",
"city": "GREENWICH",
"state": "CT",
"postal_code": "068305300",
"telephone_number": "203-869-2255",
"fax_number": "203-869-0333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "345 E 37TH ST",
"address_2": "301",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100163256",
"telephone_number": "800-984-2020",
"fax_number": "203-869-0333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHALOM",
"first_name": "DARA",
"middle_name": "ANISSA",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "T006573",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "T006573",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "DARA",
"last_name": "GREENBERG",
"middle_name": "ANISSA",
"credential": "OD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.