Individual provider Active NPI

Elaina Moyshelis, OD

  • Optometrist
  • New York, NY
National Provider Identifier
1700078086
Registry record updated Mar 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
007206 Issued in NY
Practice address
3929 Broadway
Optica Express
New York, NY 10032-1538
Phone
(212) 568-4693
Fax
(212) 568-4694
NPI assigned
Aug 10, 2007
Last updated
Mar 7, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 007206 NY Primary

Addresses

Primary practice location

3929 Broadway
Optica Express
New York, NY 10032-1538

Mailing address

Family Eyecare LLC
515 N Wood Ave Ste 102
Linden, NJ 07036-4173
Phone (908) 259-5059

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130823000545 NJ Practitioner - Optometry 3678668571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

515 N Wood Ave
Suite 102
Linden, NJ 07036-4173
Phone (908) 259-5059

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007206NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Eyecare LLC Optometrist CurrentSince Aug 1, 2013 Accepting new patients
Ae Vision LLC Optometrist CurrentSince Aug 3, 2026 Accepting new patients
A & a Optical Inc Optometrist PastSince Sep 10, 2009 Accepting new patients
Mermaid Optical Optometrist Past Accepting new patients
Tag Optical Corp Optometrist PastSince Jan 1, 2021 Accepting new patients

Locations

34-36 Progress St
Ste B4
Edison, NJ 08820
Phone (732) 515-4405

515 N Wood Ave
Ste 102
Linden, NJ 07036
Phone (908) 259-5059

515 N Wood Ave
Ste 202
Linden, NJ 07036
Phone (908) 486-3333

Organizations & group practices 5

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": "1186704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520380800000",
    "number": "1700078086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FAMILY EYECARE LLC",
            "address_2": "515 N WOOD AVE STE 102",
            "city": "LINDEN",
            "state": "NJ",
            "postal_code": "070364173",
            "telephone_number": "908-259-5059",
            "fax_number": "908-486-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3929 BROADWAY",
            "address_2": "OPTICA EXPRESS",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321538",
            "telephone_number": "212-568-4693",
            "fax_number": "212-568-4694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYSHELIS",
        "first_name": "ELAINA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-10",
        "last_updated": "2018-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "007206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.