Individual provider Active NPI

Gretchen E Ohlig, OD

  • Optometrist
  • Greenvale, NY
National Provider Identifier
1568635506
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2381 Issued in CT
Practice address
190 Wheatley PLZ
Greenvale, NY 11548-1316
Phone
(516) 686-6512
Fax
(516) 277-1591
NPI assigned
Apr 10, 2008
Last updated
Dec 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2381 CT Primary
Optometrist 152W00000X T005447 NY

Addresses

Primary practice location

190 Wheatley PLZ
Greenvale, NY 11548-1316

Mailing address

101A Norton Dr
East Northport, NY 11731-1603
Phone (203) 321-9597

Other identifiers 2

IdentifierTypeStateIssuer
D400183486OtherCTMEDICARE NGS
008053302MedicaidCT

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
I20240715000208 NY Practitioner - Optometry 4880883594 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
Accepts the Medicare-approved amount as payment in full
Group practices
Optyx LLCGroup PAC ID 6406207737, 10 clinicians

Practice addresses (Care Compare)

1092 Route 112
Port Jefferson Station, NY 11776-3043
Phone (631) 474-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T005447NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Optyx LLC Optometrist CurrentSince May 1, 2024 Accepting new patients
Optyx LLC Optometrist CurrentSince Dec 31, 2023 Accepting new patients

Locations

312 Springfield Ave
Berkeley Hts, NJ 07922
Phone (908) 336-5661

1806 Deer Park Ave
Deer Park, NY 11729
Phone (631) 667-4166

190 Wheatley Plz
Greenvale, NY 11548
Phone (516) 686-6512

10095 Main Rd
Mattituck, NY 11952
Phone (631) 213-4499

2384 Broadway
New York, NY 10024
Phone (212) 724-0850

1092 Route 112
Port Jefferson Station, NY 11776
Phone (631) 474-3937

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, 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": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1568635506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101A NORTON DR",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117311603",
            "telephone_number": "203-321-9597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 WHEATLEY PLZ",
            "city": "GREENVALE",
            "state": "NY",
            "postal_code": "115481316",
            "telephone_number": "516-686-6512",
            "fax_number": "516-277-1591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OHLIG",
        "first_name": "GRETCHEN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-10",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "2381",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "T005447",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NGS",
            "identifier": "D400183486",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008053302",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenvale, NY

Sources for this page

Verify at the official NPI Registry.