Burnside Optical Inc.

Primary specialty

OpticianTaxonomy code 156FX1800X

License

0073791 Issued in NY

Legal business name

BURNSIDE OPTICAL INC.

Practice address

54 W Burnside Ave
Bronx, NY 10453-4018

Phone

(718) 299-5454

Fax

(718) 299-0770

NPI assigned

Dec 1, 2006

Last updated

Mar 5, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Guillermo Ysmael ReyesNPI 1801964770

Title

President

Phone

(718) 299-5454

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Reyes Optica Inc.

  • Optician
  • New York, NY
  • NPI 1760758171
  NPPES parent name

Practitioners 4

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.

• Carolina Marisol Reyes, O.D.

  • Optometrist
  • Bronx, NY
  • NPI 1154909844
  Medicare reassignment NPD
• Guillermo Ysmael Reyes

  • Optician
  • Bronx, NY
  • NPI 1801964770
  NPD Authorized official
• Delvia I Moquete

  • Optician
  • Bronx, NY
  • NPI 1750563391
  NPD (past)
• Anh Van Tran, O.D

  • Optometrist
  • Bronx, NY
  • NPI 1063724169
  NPD (past)

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330905600000",
    "number": "1568530079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 W BURNSIDE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534018",
            "telephone_number": "718-299-5454",
            "fax_number": "718-299-0770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 W BURNSIDE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534018",
            "telephone_number": "718-299-5454",
            "fax_number": "718-299-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURNSIDE OPTICAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2012-03-05",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "GUILLERMO",
        "authorized_official_middle_name": "YSMAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-299-5454"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "0073791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01956270",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Ann Burns, MSED
• Kyle Burns
• Matthew Paul Burns
• Summer Rae Burns, LMSW
• Burnside Dental and Orthodontics
• Burnside Pharmacy Corp
• Burnside RX Inc (Farmacia Vida)
• Melissa Nicole Burnside, MD, MHS
• Toni Ann Burrel
• Joy Burrell-Clarke, LPN

• Optician in Bronx, NY
• Providers in Bronx, NY by specialty
• Optician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2012; 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.