Active NPI
Jamaica Vision Center Corp
- Optometrist
- Jamaica, NY
National Provider Identifier
1699209353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- JAMAICA VISION CENTER CORP
- Practice address
- 16413 Jamaica Ave
Jamaica, NY 11432 - Phone
- (646) 321-5802
- NPI assigned
- Apr 19, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Boris Bangiyev
- Title
- Owner
- Phone
- (646) 321-5802
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary |
Addresses
Primary practice location
16413 Jamaica Ave
Jamaica, NY 11432
Mailing address
16413 Jamaica Ave
Jamaica, NY 11432-4913
Phone (646) 321-5802
Other names 1
- PROFESSIONAL EYECARE CENTER
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170815003562 | NY | Part B Supplier - Clinic/Group Practice | 3779855473 |
Receives reassigned benefits from 6 practitioners Practice locations: Jamaica, NY |
National Provider Directory
National Provider DirectoryLocations
16413 Jamaica Ave
Jamaica, NY 11432
Phone (347) 419-2575
Practitioners & affiliated clinicians
Practitioners 6
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": "1492560000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1527638400000",
"number": "1699209353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16413 JAMAICA AVE",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114324913",
"telephone_number": "646-321-5802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16413 JAMAICA AVE",
"city": "JAMAICA",
"state": "NY",
"postal_code": "11432",
"telephone_number": "646-321-5802"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JAMAICA VISION CENTER CORP",
"organizational_subpart": "NO",
"enumeration_date": "2017-04-19",
"last_updated": "2018-05-30",
"status": "A",
"authorized_official_last_name": "BANGIYEV",
"authorized_official_first_name": "BORIS",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "646-321-5802",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "PROFESSIONAL EYECARE CENTER",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 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.