NPIMap

Organization Active NPI

Tag Optical Corp

  • Optometrist
  • New York, NY
National Provider Identifier
1619090917
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV005225-1 Issued in NY
Legal business name
TAG OPTICAL CORP
Doing business as
Optica Express
Practice address
3929 Broadway
New York, NY 10032-1538
Phone
(212) 568-4693
NPI assigned
Apr 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Authorized official

Name
Tracey RomanoNPI 1871627646
Title
Manager
Phone
(212) 568-4693

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X TUV005225-1 NY Primary

Addresses

Primary practice location

3929 Broadway
New York, NY 10032-1538

Mailing address

3929 Broadway
New York, NY 10032-1538

Other names 1

  • Optica Express Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210316000765 NY Part B Supplier - Clinic/Group Practice 5395635395 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

3929 Broadway
New York, NY 10032
Phone (212) 568-4693

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614556800000",
    "number": "1619090917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3929 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3929 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321538",
            "telephone_number": "212-568-4693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAG OPTICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A",
        "authorized_official_last_name": "ROMANO",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "212-568-4693"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV005225-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optica Express",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Optica Express",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 1, 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.