Individual provider Active NPI

Frank Vito Cristallo III, OD

  • Optometrist
  • Bronx, NY
National Provider Identifier
1649951310
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
009873 Issued in NY
Practice address
90 W 225TH St
Bronx, NY 10463-7002
Phone
(718) 664-2164
NPI assigned
Jul 26, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 009873 NY Primary

Addresses

Primary practice location

90 W 225TH St
Bronx, NY 10463-7002

Mailing address

44 Michel Ave
Farmingdale, NY 11735-4527
Phone (516) 241-6550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
009873NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
National Vision, Inc. PastSince Jul 31, 2023 Accepting new patients

Organizations & group practices 1

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": "1690329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1649951310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 MICHEL AVE",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117354527",
            "telephone_number": "516-241-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 W 225TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104637002",
            "telephone_number": "718-664-2164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISTALLO",
        "first_name": "FRANK",
        "middle_name": "VITO",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-26",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "009873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.