Individual provider Active NPI

Rita Ellent, O.D.

  • Optometrist
  • Jackson Heights, NY
National Provider Identifier
1649278953
Registry record updated Jul 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
VUT005856 Issued in NY
Practice address
8325 37TH Ave
Jackson Heights, NY 11372-7320
Phone
(718) 426-2725
NPI assigned
Jul 11, 2005
Last updated
Jul 17, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X VUT005856 NY Primary

Addresses

Primary practice location

8325 37TH Ave
Jackson Heights, NY 11372-7320

Mailing address

12 Station SQ
Forest Hills, NY 11375-5234
Phone (917) 803-0002

Other identifiers 2

IdentifierTypeStateIssuer
49890OtherNYDAVIS
02287781MedicaidNY

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
I20040609000416 NY Practitioner - Optometry 0648253989 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12 Station SQ
Forest Hills, NY 11375-5234
Phone (917) 803-0002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
VUT005856NYMDOptometrist
005856NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
S and B Optometry Care, P.C. Optometrist CurrentSince Jul 17, 2013 Accepting new patients
Jackson Heights Optical Inc Optometrist PastSince Jan 17, 2013 Accepting new patients

Locations

12 Station Sq
Forest Hills, NY 11375
Phone (718) 480-1050

Interoperability endpoints

  • Direct secure messaging: rita.ellent@uprisedirect.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374019200000",
    "number": "1649278953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 STATION SQ",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755234",
            "telephone_number": "917-803-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8325 37TH AVE",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727320",
            "telephone_number": "718-426-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLENT",
        "first_name": "RITA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-11",
        "last_updated": "2013-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "VUT005856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS",
            "identifier": "49890",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02287781",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson Heights, NY

Sources for this page

Verify at the official NPI Registry.