Vistasite Optique Inc

Primary specialty

Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X

Legal business name

VISTASITE OPTIQUE INC

Doing business as

Vistasite

Practice address

4204 Broadway
New York, NY 10033-3706

Phone

(917) 261-6100

Fax

(917) 861-6697

NPI assigned

May 2, 2018

Last updated

Mar 15, 2021By 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

Vladimir Dvoretsky, ODNPI 1336294636

Title

OD

Phone

(212) 433-0136

Specialties & licenses 1

Addresses

Other names 1

• Vistasite Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 3

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.

• Vladimir Dvoretsky, O.D.

  • Optometrist
  • New York, NY
  • NPI 1336294636
  Medicare reassignment NPD Authorized official
• Martin Alex Mundackal, OD

  • Optometrist
  • New York, NY
  • NPI 1114816634
  Medicare reassignment NPD
• Eugene Orloff, OD

  • Optometrist
  • Bronx, NY
  • NPI 1386731974
  Medicare reassignment NPD

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

{
    "created_epoch": "1525219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615766400000",
    "number": "1578052791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4204 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100333706",
            "telephone_number": "917-261-6100",
            "fax_number": "917-861-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4204 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100333706",
            "telephone_number": "917-261-6100",
            "fax_number": "917-861-6697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTASITE OPTIQUE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-02",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A",
        "authorized_official_last_name": "DVORETSKY",
        "authorized_official_first_name": "VLADIMIR",
        "authorized_official_title_or_position": "OD",
        "authorized_official_telephone_number": "212-433-0136",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vistasite",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vista Alliance Eye Care
• Vista Optometry and Ophthalmic Dispensing Care PLLC (Vista Site Eyecare)
• Vista Psychological Services
• Vistasite Eye Group Inc
• Vistasite Hamilton Corp
• Vistasite Vision Center Inc.
• Sarah Vistica, MPAS
• Visual Diagnostics
• Visual Images
• Pallavi Visvanathan, PHD

• Ophthalmologic Surgery Clinic/Center in New York, NY
• Providers in New York, NY by specialty
• Ophthalmologic Surgery Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; 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.