NPIMap

Organization Active NPI

Eyecare Advantage, Inc.

  • Optometrist
  • Bay Shore, NY
National Provider Identifier
1700192580
Registry record updated Jan 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV0033655-1 Issued in NY
Legal business name
EYECARE ADVANTAGE, INC.
Doing business as
Eyecare Vision Services
Practice address
1555 Sunrise Hwy
Bay Shore, NY 11706-6027
Phone
(631) 647-8859
NPI assigned
Aug 31, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2016

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

Authorized official

Name
Michelle Vanessa Gibson
Title
Director
Phone
(631) 647-8859

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X TUV0033655-1 NY Primary
Eyewear Supplier 332H00000X

Addresses

Primary practice location

1555 Sunrise Hwy
Bay Shore, NY 11706-6027

Mailing address

1953 Grand Ave
North Baldwin, NY 11510-2820
Phone (631) 647-8862

Other names 1

  • Eyecare Vision Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Eyecare Advantage Inc26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Locations

1555 Sunrise Hwy
Bay Shore, NY 11706
Phone (631) 666-1615

Practitioners & affiliated clinicians

Practitioners 1

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": "1283212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452211200000",
    "number": "1700192580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1953 GRAND AVE",
            "city": "NORTH BALDWIN",
            "state": "NY",
            "postal_code": "115102820",
            "telephone_number": "631-647-8862",
            "fax_number": "631-647-8859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 SUNRISE HWY",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117066027",
            "telephone_number": "631-647-8859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE ADVANTAGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-31",
        "last_updated": "2016-01-08",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "VANESSA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "631-647-8859"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV0033655-1",
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eyecare Vision Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.