Individual provider Active NPI

Jade R Gormady, O.D.

  • Optometrist
  • New York, NY
National Provider Identifier
1649551391
Registry record updated May 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV007705 Issued in NY
Practice address
128 Ft Washingtn Ave Apt J
New York, NY 10032-4735
Phone
(212) 928-9590
Fax
(212) 569-9100
NPI assigned
Sep 7, 2011
Last updated
May 7, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV007705 NY Primary

Addresses

Primary practice location

128 Ft Washingtn Ave Apt J
New York, NY 10032-4735

Mailing address

128 Ft Washingtn Ave Apt J
New York, NY 10032-4735
Phone (212) 928-9590

Other identifiers 1

IdentifierTypeStateIssuer
03399891MedicaidNY

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
I20111227000135 NY Practitioner - Optometry 8921274820 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jeffrey Cooper OD PCGroup PAC ID 8628042892, 13 clinicians

Practice addresses (Care Compare)

161 S Central Ave
Hartsdale, NY 10530-2314
Phone (914) 948-1700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV007705NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Optometry Care PC Optometrist CurrentSince Oct 23, 2023 Accepting new patients
Jeffrey Cooper OD PC CurrentSince Jan 21, 2024 Accepting new patients
Hall of Frames Opthalmic Dispensing PC CurrentSince Oct 6, 2015 Accepting new patients
Jeffrey Cooper O.D., P.C. Optometrist Current Accepting new patients
Jeffrey Cooper O.D., P.C. Optometrist CurrentSince Jan 21, 2024 Accepting new patients
Jeffrey Cooper O.D., P.C. Optometrist Past Accepting new patients
Jeffrey Cooper O.D., P.C. Optometrist Past Accepting new patients
Washington Heights Optical Inc. PastSince Aug 20, 2007 Accepting new patients
Jeffrey Cooper O.D., P.C. Optometrist Past Accepting new patients

Locations

1038 Southern Blvd
Bronx, NY 10459
Phone (718) 328-7137

1332 Metropolitan Ave
Bronx, NY 10462
Phone (718) 828-6200

25 Westchester Sq
Bronx, NY 10461
Phone (718) 597-6162

385 E 149th St
Bronx, NY 10455
Phone (347) 385-2633

471 E Tremont Ave
Bronx, NY 10457
Phone (718) 583-0444

815 Hutchinson River Pkwy
Bronx, NY 10465
Phone (718) 536-2690

161 S Central Ave
Hartsdale, NY 10530
Phone (914) 902-8845

Organizations & group practices 9

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": "1315353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336348800000",
    "number": "1649551391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 FT WASHINGTN AVE APT J",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100324735",
            "telephone_number": "212-928-9590",
            "fax_number": "212-569-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 FT WASHINGTN AVE APT J",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100324735",
            "telephone_number": "212-928-9590",
            "fax_number": "212-569-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORMADY",
        "first_name": "JADE",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-07",
        "last_updated": "2012-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03399891",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.