Active NPI
Richard Chavis
- Optician
- New York, NY
National Provider Identifier
1598867418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 006252
- Practice address
- 187 E 116TH St
Wizard of Eyes
New York, NY 10029-1342 - Phone
- (212) 996-7676
- NPI assigned
- Sep 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Optician | 156FX1800X | 006252 | NY | Primary |
Addresses
Primary practice location
187 E 116TH St
Wizard of Eyes
New York, NY 10029-1342
Mailing address
26 Pebble Brook Dr
Carmel, NY 10512-4317
Phone (845) 208-3345
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01371815 | Medicaid | NY |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006252 | NY | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wizard of Eyes of 116 St Inc | Optician | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598867418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26 PEBBLE BROOK DR",
"city": "CARMEL",
"state": "NY",
"postal_code": "105124317",
"telephone_number": "845-208-3345",
"fax_number": "845-208-3344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "187 E 116TH ST",
"address_2": "WIZARD OF EYES",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100291342",
"telephone_number": "212-996-7676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAVIS",
"first_name": "RICHARD",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NY",
"license": "006252",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01371815",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}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.