Individual provider Active NPI

Kirk Kaupke

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1669880811
Registry record updated Jul 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
008217 Issued in NY
Practice address
505 Flushing Avenue
Unit 1C
Brooklyn, NY 11205-1688
Phone
(718) 522-3332
Fax
(718) 522-3319
NPI assigned
Jul 31, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 008217 NY Primary

Addresses

Primary practice location

505 Flushing Avenue
Unit 1C
Brooklyn, NY 11205-1688

Mailing address

505 Flushing Avenue
Unit 1C
Brooklyn, NY 11205-1688
Phone (718) 522-3332

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
I20141029001733 NY Practitioner - Optometry 6204057524 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008217NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
NK Optometry PLLC Optometrist CurrentSince Jan 1, 2018 Accepting new patients
Vision Nyc Jonathan Kruh MD PLLC CurrentSince Jan 15, 2019 Accepting new patients
Millenia RX Corp CurrentSince Nov 9, 2025 Accepting new patients
Cono M.Grasso, M.D.P.C. CurrentSince Jan 15, 2019 Accepting new patients
Monroe Visions Optometrist Past Accepting new patients

Locations

233B E 149th St
Bronx, NY 10451
Phone (407) 574-0433

3539 Riverdale Ave
Bronx, NY 10463
Phone (718) 489-6290

326 7th St
Fl 2
Brooklyn, NY 11215
Phone (718) 489-6290

Organizations & group practices 5

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": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406764800000",
    "number": "1669880811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 FLUSHING AVENUE",
            "address_2": "UNIT 1C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112051688",
            "telephone_number": "718-522-3332",
            "fax_number": "718-522-3319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 FLUSHING AVENUE",
            "address_2": "UNIT 1C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112051688",
            "telephone_number": "718-522-3332",
            "fax_number": "718-522-3319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUPKE",
        "first_name": "KIRK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-31",
        "last_updated": "2014-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "008217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.