Individual provider Active NPI

David Reyes, OD

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1659495372
Registry record updated Aug 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T0052871 Issued in NY
Practice address
1354 Pennsylvania Ave
Brooklyn, NY 11239-2111
Phone
(718) 642-3526
Fax
(718) 642-3496
NPI assigned
Mar 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T0052871 NY Primary

Addresses

Primary practice location

1354 Pennsylvania Ave
Brooklyn, NY 11239-2111

Mailing address

18012 Union Tpke
Fresh Meadows, NY 11366-1620
Phone (718) 380-5353

Other identifiers 1

IdentifierTypeStateIssuer
01321342MedicaidNY

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
I20120320000240 NY Practitioner - Optometry 0840450490 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1991
Medicare assignment
May accept Medicare assignment
Group practices
1354 Nyc Optical LLCGroup PAC ID 2163807090, 3 clinicians
Linden Eye Care IncGroup PAC ID 8325349947, 4 clinicians
589 Nyc Optical LLCGroup PAC ID 2860861846, 3 clinicians

Practice addresses (Care Compare)

1354 PA Ave
Brooklyn, NY 11239-2111
Phone (718) 642-3526

2084 Linden Blvd
Brooklyn, NY 11207-7412
Phone (718) 272-3700

589 Sutter Ave
Brooklyn, NY 11207-4002
Phone (347) 627-7896

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T0052871NYMDOptometrist
005287NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
589 Nyc Optical LLC Optometrist CurrentSince Aug 18, 2022 Accepting new patients
Linden Eye Care Inc Optometrist CurrentSince Oct 13, 2015 Accepting new patients
1354 Nyc Optical LLC Optometrist CurrentSince May 29, 2023 Accepting new patients
Nyc Optical Group LLC Optometrist CurrentSince May 1, 2019 Accepting new patients
Linden Eye Care, Inc Optometrist CurrentSince Oct 13, 2015 Accepting new patients
Shades of Nostrand Inc. Past Accepting new patients

Locations

811 Southern Blvd
Bronx, NY 10459
Phone (347) 326-8999

625 E Fordham Rd
Bronx, NY 10458
Phone (718) 409-3433

589 Sutter Ave
Brooklyn, NY 11207
Phone (347) 627-7896

5623 5th Ave
Brooklyn, NY 11220
Phone (718) 635-9333

2084 Linden Blvd
Brooklyn, NY 11207
Phone (718) 272-3700

482 86th St
Brooklyn, NY 11209
Phone (718) 879-8182

1354 Pennsylvania Ave
Brooklyn, NY 11239
Phone (718) 642-3526

Organizations & group practices 6

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": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1659495372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18012 UNION TPKE",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661620",
            "telephone_number": "718-380-5353",
            "fax_number": "718-380-5396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1354 PENNSYLVANIA AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112392111",
            "telephone_number": "718-642-3526",
            "fax_number": "718-642-3496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "T0052871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01321342",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.