Organization Active NPI

Koi Vision Optometry, PLLC

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1669352597
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
KOI VISION OPTOMETRY, PLLC
Practice address
211 McGuinness Blvd Ste 1
Brooklyn, NY 11222-6787
Phone
(954) 298-5841
NPI assigned
Sep 3, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Authorized official

Name
Dr. Sarah Phen, ODNPI 1619642378
Title
Doctor of Optometry
Phone
(954) 298-5841

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

211 McGuinness Blvd Ste 1
Brooklyn, NY 11222-6787

Mailing address

166 Elizabeth St
New York, NY 10012-4628

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260320001930 NY Part B Supplier - Clinic/Group Practice 2365926003 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

166 Elizabeth St
New York, NY 10012

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1756857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756857600000",
    "number": "1669352597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 ELIZABETH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100124628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 MCGUINNESS BLVD STE 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112226787",
            "telephone_number": "954-298-5841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOI VISION OPTOMETRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-03",
        "last_updated": "2025-09-03",
        "certification_date": "2025-08-25",
        "status": "A",
        "authorized_official_last_name": "PHEN",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "DOCTOR OF OPTOMETRY",
        "authorized_official_telephone_number": "954-298-5841",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.