Individual provider Active NPI

Dmitriy Israel, OPHTHALMIC DISPENSER

  • Optician
  • Hewlett, NY
National Provider Identifier
1659505204
Registry record updated May 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
008903 Issued in NY
Practice address
1332 Peninsula Blvd
Hewlett, NY 11557
Phone
(516) 792-3013
Fax
(516) 792-3013
NPI assigned
May 12, 2009
Last updated
May 12, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 008903 NY Primary

Addresses

Primary practice location

1332 Peninsula Blvd
Hewlett, NY 11557

Mailing address

6607 99TH Street 2a
Rego Park, NY 11374
Phone (516) 792-3012

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
008903NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Dima Lauren LLC Current Accepting new patients
North Shore Lij, Urgent Care, P.C. PastSince Apr 14, 2020 Accepting new patients
View West Optical Inc Optician Past Accepting new patients

Organizations & group practices 3

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": "1242086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242086400000",
    "number": "1659505204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6607 99TH STREET 2A",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "11374",
            "telephone_number": "516-792-3012",
            "fax_number": "516-792-3013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1332 PENINSULA BLVD",
            "city": "HEWLETT",
            "state": "NY",
            "postal_code": "11557",
            "telephone_number": "516-792-3013",
            "fax_number": "516-792-3013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISRAEL",
        "first_name": "DMITRIY",
        "credential": "OPHTHALMIC DISPENSER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-12",
        "last_updated": "2009-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "008903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hewlett, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2009; 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.