Organization Active NPI

Long Island Eye Surgeons, PC

  • Ophthalmology Physician
  • Manhasset, NY
National Provider Identifier
1699892976
Registry record updated Jan 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
109382 Issued in NY
Legal business name
LONG ISLAND EYE SURGEONS, PC
Practice address
2110 Northern Blvd
Suite 208
Manhasset, NY 11030-3502
Phone
(516) 627-5113
Fax
(516) 365-2817
NPI assigned
Mar 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2009

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

Authorized official

Name
Mrs. Tracey A Ortiz
Title
Administrator
Phone
(516) 627-5113

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 109382 NY Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

2110 Northern Blvd
Suite 208
Manhasset, NY 11030-3502

Mailing address

2110 Northern Blvd
Suite 208
Manhasset, NY 11030-3502
Phone (516) 627-5113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090209000138 NY Part B Supplier - Clinic/Group Practice 9133284177 Receives reassigned benefits from 4 practitioners
Practice locations: New Hyde Park, NY
O20100930069114 NY DME Supplier - Physician - Ophthalmology 9133284177 Practice locations: Lake Success, NY

National Provider Directory

National Provider Directory

Locations

1981 Marcus Ave
Ste E115
North New Hyde Park, NY 11042
Phone (516) 627-5113

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": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233014400000",
    "number": "1699892976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 NORTHERN BLVD",
            "address_2": "SUITE 208",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303502",
            "telephone_number": "516-627-5113",
            "fax_number": "516-365-2817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 NORTHERN BLVD",
            "address_2": "SUITE 208",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303502",
            "telephone_number": "516-627-5113",
            "fax_number": "516-365-2817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND EYE SURGEONS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2009-01-27",
        "status": "A",
        "authorized_official_last_name": "ORTIZ",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "516-627-5113",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "109382",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2009; 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.