NPIMap

Organization Active NPI

Tanya Jacobson, OD., LLC

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1669401394
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV005630-1 Issued in NY
Legal business name
TANYA JACOBSON, OD., LLC
Practice address
379 Knickerbocker Ave
Brooklyn, NY 11237-3701
Phone
(718) 418-1268
NPI assigned
Jul 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Tanya Dina Jacobson, O.D.NPI 1033151477
Title
Proprietor
Phone
(917) 854-2430

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 TUV005630-1 NY Primary

Addresses

Primary practice location

379 Knickerbocker Ave
Brooklyn, NY 11237-3701

Mailing address

535 Crown St
Brooklyn, NY 11213-5126
Phone (917) 854-2430

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669401394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 CROWN ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112135126",
            "telephone_number": "917-854-2430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 KNICKERBOCKER AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112373701",
            "telephone_number": "718-418-1268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANYA JACOBSON, OD., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "TANYA",
        "authorized_official_middle_name": "DINA",
        "authorized_official_title_or_position": "PROPRIETOR",
        "authorized_official_telephone_number": "917-854-2430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV005630-1",
            "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 Aug 22, 2020; 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.