Active NPI
Optiglaz Inc.
- Optician
- Brooklyn, NY
National Provider Identifier
1720039035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- Legal business name
- OPTIGLAZ INC.
- Doing business as
- Empire OPTICAL
- Practice address
- 720 Brighton Beach Ave
Brooklyn, NY 11235-6412 - Phone
- (718) 891-6400
- Fax
- (718) 891-6400
- NPI assigned
- May 12, 2006
- 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
- Svetlana Petatsky
- Title
- President
- Phone
- (718) 891-6400
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | Primary |
Addresses
Primary practice location
720 Brighton Beach Ave
Brooklyn, NY 11235-6412
Mailing address
720 Brighton Beach Ave
Brooklyn, NY 11235-6412
Phone (718) 891-6400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01472980 | Medicaid | NY |
Other names 1
- Empire OPTICAL
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 2
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Optiglaz Inc, Dba Empire Optical | Prosthetic Lenses: Prosthetics Cataract Lenses | Accepts assignment |
National Provider Directory
National Provider DirectoryLocations
720 Brighton Beach Ave
Brooklyn, NY 11235
Phone (718) 891-6400
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- Brooklyn, NY
- NPI 1831171743
-
- Optometrist
- Brooklyn, NY
- NPI 1548263833
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1317340800000",
"number": "1720039035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "720 BRIGHTON BEACH AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112356412",
"telephone_number": "718-891-6400",
"fax_number": "718-891-6400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 BRIGHTON BEACH AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112356412",
"telephone_number": "718-891-6400",
"fax_number": "718-891-6400"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OPTIGLAZ INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-12",
"last_updated": "2011-09-30",
"status": "A",
"authorized_official_last_name": "PETATSKY",
"authorized_official_first_name": "SVETLANA",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "718-891-6400"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Technician/Technologist, Optician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01472980",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Empire OPTICAL",
"code": "3",
"type": "Doing Business As"
}
]
}
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 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.