Individual provider Active NPI

Ilana Gelfond-Polnariev, OD

  • Pediatric Optometrist
  • Staten Island, NY
National Provider Identifier
1619972361
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric OptometristTaxonomy code 152WP0200X
License
TUV006588 Issued in NY
Practice address
4079 Richmond Ave
Staten Island, NY 10312-5633
Phone
(718) 481-2020
Fax
(347) 824-2010
NPI assigned
Jun 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Optometrist 152WP0200X TUV006588 NY Primary

Addresses

Primary practice location

4079 Richmond Ave
Staten Island, NY 10312-5633

Mailing address

4079 Richmond Ave
Staten Island, NY 10312-5633
Phone (718) 481-2020

Other identifiers 1

IdentifierTypeStateIssuer
02499796MedicaidNY

Other names 1

  • Dr. Ilana Gelfond Former name

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
I20040415000108 NY Practitioner - Optometry 4880689454 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2002
Medicare assignment
May accept Medicare assignment
Group practices
L'Refuah Medical and Rehabilitation Center, Inc.Group PAC ID 8628068731, 17 clinicians
Ilana Gelfond Polnariev OD PCGroup PAC ID 6608145123, 2 clinicians

Practice addresses (Care Compare)

3710 13TH Ave
Brooklyn, NY 11218-3602
Phone (718) 686-7600

4079 Richmond Ave
Staten Island, NY 10312-5633
Phone (718) 481-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV006588NYMDPediatric Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
L'Refuah Medical & Rehabilitation Center, Inc. CurrentSince Jun 1, 2003 Accepting new patients
L'Refuah Medical & Rehabilitation Center, Inc. CurrentSince Jun 1, 2003 Accepting new patients
Ilana Gelfond Polnariev OD PC Pediatrics CurrentSince Jul 1, 2017 Accepting new patients
Med Group LLC Past Accepting new patients
State of New York Comptrollers Office Past Accepting new patients
Omni Eye Specialists P a Past Accepting new patients
D.S. Optometric Services PC Past Accepting new patients

Locations

1312 38th St
Brooklyn, NY 11218
Phone (718) 686-2374

4300 Hylan Blvd
Ste 1BC
Staten Island, NY 10312
Phone (718) 481-2020

4079 Richmond Ave
Staten Island, NY 10312
Phone (718) 481-2020

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: ilana.gelfondpolnariev.p1@direct.ezramedical.nextgenshare.com

Organizations & group practices 7

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": "1119052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1619972361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4079 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103125633",
            "telephone_number": "718-481-2020",
            "fax_number": "347-824-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4079 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103125633",
            "telephone_number": "718-481-2020",
            "fax_number": "347-824-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELFOND-POLNARIEV",
        "first_name": "ILANA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-18",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "NY",
            "license": "TUV006588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02499796",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ILANA",
            "last_name": "GELFOND",
            "prefix": "DR.",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.