Individual provider Active NPI

Anna Marie Fernandez, OD

  • Optometrist
  • Staten Island, NY
National Provider Identifier
1619089794
Registry record updated Jun 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV004573 Issued in NY
Practice address
2655 Richmond Ave Ste 114
Staten Island, NY 10314
Phone
(718) 761-5607
Fax
(718) 761-5452
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV004573 NY Primary

Addresses

Primary practice location

2655 Richmond Ave Ste 114
Staten Island, NY 10314

Mailing address

2655 Richmond Ave Ste 114
Staten Island, NY 10314-5821
Phone (718) 761-5607

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
I20090427000120 NY Practitioner - Optometry 3678621927 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York at Buffalo School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4255 Amboy Rd
Suite 7
Staten Island, NY 10308-2310
Phone (718) 554-4100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV004573NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Empire Vision Center, Inc CurrentSince Jan 14, 2021 Accepting new patients
Empire Vision Center Inc Optometrist CurrentSince Jan 14, 2021 Accepting new patients

Locations

494 Gateway Dr
Unit K12
Brooklyn, NY 11239
Phone (718) 227-3120

2680 Delaware Ave
Ste C
Buffalo, NY 14216
Phone (716) 873-1241

9141 Queens Blvd
Flushing, NY 11373
Phone (718) 458-2631

560 Troy Schenectady Rd
#7
Latham, NY 12110
Phone (518) 783-0090

1930 South Rd
#105
Poughkeepsie, NY 12601
Phone (845) 298-3200

2590 W Ridge Rd
Rochester, NY 14626
Phone (585) 227-7150

2921 Erie Blvd E
Syracuse, NY 13224
Phone (315) 446-3145

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527897600000",
    "number": "1619089794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 RICHMOND AVE STE 114",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145821",
            "telephone_number": "718-761-5607",
            "fax_number": "718-761-5452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 RICHMOND AVE STE 114",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10314",
            "telephone_number": "718-761-5607",
            "fax_number": "718-761-5452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "ANNA MARIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2018-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV004573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.