Organization Active NPI

Vista Vision Optical, Inc

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1700042421
Registry record updated Sep 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV003774 Issued in NY
Legal business name
VISTA VISION OPTICAL, INC
Practice address
337 Knickerbocker Ave
Brooklyn, NY 11237-3752
Phone
(718) 456-2834
NPI assigned
Aug 1, 2008
Last updated
Sep 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2008

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

Authorized official

Name
Dr. David R. Nathanson, O.D.NPI 1598730236
Title
President
Phone
(516) 551-7844

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
Optometrist 152W00000X TUV003774 NY Primary

Addresses

Primary practice location

337 Knickerbocker Ave
Brooklyn, NY 11237-3752

Mailing address

337 Knickerbocker Ave
Brooklyn, NY 11237-3752
Phone (718) 456-2834

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140708001033 NY Part B Supplier - Clinic/Group Practice 3971623729 Receives reassigned benefits from 2 practitioners
Practice locations: Brooklyn, NY; Great Neck, NY

National Provider Directory

National Provider Directory

Locations

46 Middle Neck Rd
Great Neck, NY 11021
Phone (516) 487-8866

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": "1217548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221609600000",
    "number": "1700042421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "337 KNICKERBOCKER AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112373752",
            "telephone_number": "718-456-2834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "337 KNICKERBOCKER AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112373752",
            "telephone_number": "718-456-2834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA VISION OPTICAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-01",
        "last_updated": "2008-09-17",
        "status": "A",
        "authorized_official_last_name": "NATHANSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-551-7844",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV003774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2008; 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.