Active NPI
Komal M. Malik, O.D.
- Optometrist
- New Hyde Park, NY
National Provider Identifier
1609245943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TUV0082781
- Practice address
- 1991 Marcus Ave
2ND Floor
New Hyde Park, NY 11042-2057 - Phone
- (516) 354-1600
- Fax
- (516) 941-4677
- NPI assigned
- Sep 16, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | TUV0082781 | NY | Primary |
Addresses
Primary practice location
1991 Marcus Ave
2ND Floor
New Hyde Park, NY 11042-2057
Mailing address
55 Water St
New York, NY 10041-0004
Phone (646) 680-2888
Other practice location 1
1991 Marcus Ave
2nd Floor
New Hyde Park, NY 11042-2057
Phone (516) 354-1600
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TUV0082781 | NY | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clearview Ophthalmology PC | 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.
-
- Ophthalmology Physician
- Astoria, NY
- NPI 1558558288
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510272000000",
"number": "1609245943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 WATER ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100410004",
"telephone_number": "646-680-2888",
"fax_number": "516-542-5556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1991 MARCUS AVE",
"address_2": "2ND FLOOR",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "110422057",
"telephone_number": "516-354-1600",
"fax_number": "516-941-4677"
}
],
"practiceLocations": [
{
"address_1": "1991 Marcus Ave",
"address_2": "2nd Floor",
"address_purpose": "LOCATION",
"city": "New Hyde Park",
"state": "NY",
"postal_code": "110422057",
"country_code": "US",
"telephone_number": "516-354-1600",
"fax_number": "516-941-4672",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MALIK",
"first_name": "KOMAL",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-16",
"last_updated": "2017-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "TUV0082781",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New Hyde Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.