Organization Active NPI

R S Family Eye Medical Care PC

  • Ophthalmology Physician
  • Rego Park, NY
National Provider Identifier
1679071195
Registry record updated Jan 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
R S FAMILY EYE MEDICAL CARE PC
Practice address
9732 63Rd Rd
Rego Park, NY 11374-1639
Phone
(347) 730-4606
NPI assigned
Jan 30, 2018
Last updated
Jan 30, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2018

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

Authorized official

Name
Richard Scott Russell, MDNPI 1598772923
Title
MD
Phone
(347) 730-4606

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
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

9732 63Rd Rd
Rego Park, NY 11374-1639

Mailing address

7119 168TH St
Fresh Meadows, NY 11365-3241
Phone (347) 730-4606

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181109001085 NY Part B Supplier - Clinic/Group Practice 3274887260 Receives reassigned benefits from 3 practitioners
Practice locations: Rego Park, NY

National Provider Directory

National Provider Directory

Locations

9728 63rd Rd
Rego Park, NY 11374
Phone (347) 730-4606

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1517270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517270400000",
    "number": "1679071195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7119 168TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113653241",
            "telephone_number": "347-730-4606",
            "fax_number": "855-310-5525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9732 63RD RD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741639",
            "telephone_number": "347-730-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R S FAMILY EYE MEDICAL CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-30",
        "last_updated": "2018-01-30",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "347-730-4606",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2018; 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.