Active NPI
Andy Ruan
- Optometrist
- New York, NY
National Provider Identifier
1679240618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 009441
- Practice address
- 1430 3Rd Ave
New York, NY 10028-1904 - Phone
- (917) 432-5403
- NPI assigned
- Aug 26, 2021
- Last updated
- Aug 26, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 009441 | NY | Primary |
Addresses
Primary practice location
1430 3Rd Ave
New York, NY 10028-1904
Mailing address
872 67TH St
Brooklyn, NY 11220-5706
Phone (646) 309-7264
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pennsylvania College of Optometry, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
4000 Luxottica PL
Mason, OH 45040-8114
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009441 | NY | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luxottica of America Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629936000000",
"number": "1679240618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "872 67TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112205706",
"telephone_number": "646-309-7264"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1430 3RD AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100281904",
"telephone_number": "917-432-5403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUAN",
"first_name": "ANDY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-26",
"last_updated": "2021-08-26",
"certification_date": "2021-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "009441",
"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 Aug 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.