Individual provider Active NPI

Nicole J Mizrahi, O. D.

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1558714188
Registry record updated Jul 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T008492-1 Issued in NY
Practice address
5920 8TH Ave
Brooklyn, NY 11220-4388
Phone
(347) 770-8300
NPI assigned
Jul 19, 2016
Last updated
Jul 19, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T008492-1 NY Primary

Addresses

Primary practice location

5920 8TH Ave
Brooklyn, NY 11220-4388

Mailing address

1965 E 9TH St
Brooklyn, NY 11223-3241
Phone (917) 880-0471

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
I20241104002063 NY Practitioner - Optometry 6204369820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Century Medical and Dental Center IncGroup PAC ID 8729070669, 107 clinicians

Practice addresses (Care Compare)

2315 3Rd Ave
New York, NY 10035-1733
Phone (212) 540-5020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T008492-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Century Medical & Dental Center Inc CurrentSince Aug 30, 2024 Accepting new patients

Locations

200 Livingston St
Brooklyn, NY 11201
Phone (718) 522-3399

260 Avenue X
Brooklyn, NY 11223
Phone (718) 336-8855

2315 3rd Ave
New York, NY 10035
Phone (212) 369-5566

827 11th Ave
New York, NY 10019
Phone (212) 257-9778

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": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468886400000",
    "number": "1558714188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1965 E 9TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112233241",
            "telephone_number": "917-880-0471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5920 8TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112204388",
            "telephone_number": "347-770-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZRAHI",
        "first_name": "NICOLE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-19",
        "last_updated": "2016-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "T008492-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.