Organization Active NPI

Family Optometry 121 PC

  • Optometrist
  • New York, NY
National Provider Identifier
1669710067
Registry record updated Jun 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV007232 Issued in NY
Legal business name
FAMILY OPTOMETRY 121 PC
Practice address
203 E 121St St
New York, NY 10035-3018
Phone
(212) 876-2957
NPI assigned
Jan 21, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2013

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

Authorized official

Name
Aliya HotNPI 1023284833
Title
Owner/Optometrist
Phone
(212) 876-2957

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 TUV007232 NY Primary

Addresses

Primary practice location

203 E 121St St
New York, NY 10035-3018

Mailing address

203 E 121St St
New York, NY 10035-3018
Phone (212) 876-2957

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130419000017 NY Part B Supplier - Clinic/Group Practice 8729224688 Receives reassigned benefits from 2 practitioners
Practice locations: New York, NY; Bronx, NY

National Provider Directory

National Provider Directory
Tax ID family
Family Optometry 121 PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the 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": "1358726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370908800000",
    "number": "1669710067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 E 121ST ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100353018",
            "telephone_number": "212-876-2957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 E 121ST ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100353018",
            "telephone_number": "212-876-2957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY OPTOMETRY 121 PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-21",
        "last_updated": "2013-06-11",
        "status": "A",
        "authorized_official_last_name": "HOT",
        "authorized_official_first_name": "ALIYA",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "212-876-2957"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; 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.