Organization Active NPI

Optiglaz Inc.

  • Optician
  • Brooklyn, NY
National Provider Identifier
1720039035
Registry record updated Sep 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
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

Updated by the provider on Sep 30, 2011

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)CodeLicenseStatePrimary
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
01472980MedicaidNY

Other names 1

  • Empire OPTICAL Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930031173 NY DME Supplier - Optician 2860381688 Practice locations: Brooklyn, NY
O20111118000513 NY Part B Supplier - Clinic/Group Practice 2860381688 Receives reassigned benefits from 2 practitioners
Practice locations: Brooklyn, NY

Laboratory certificates & supplier records

Derived by NPIMap

These 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

SupplierSuppliesMedicare assignment
Optiglaz Inc, Dba Empire Optical720 Brighton Beach Ave, Brooklyn, NY 11235-6412(718) 891-6400 Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.