Organization Active NPI

Vogue Optical LTD

  • Optician
  • Brooklyn, NY
National Provider Identifier
1720175938
Registry record updated Oct 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
008999 Issued in NY
Legal business name
VOGUE OPTICAL LTD
Practice address
3723 Nostrand Ave
Brooklyn, NY 11235-1907
Phone
(718) 646-6200
Fax
(718) 648-0836
NPI assigned
Oct 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2012

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

Authorized official

Name
Leonid Yusim, O.D.
Title
President
Phone
(718) 646-6200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X 008999 NY Primary

Addresses

Primary practice location

3723 Nostrand Ave
Brooklyn, NY 11235-1907

Mailing address

3723 Nostrand Ave
Brooklyn, NY 11235-1907
Phone (718) 646-6200

Other identifiers 1

IdentifierTypeStateIssuer
01777297MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100413000006 NY Part B Supplier - Clinic/Group Practice 4284524281 Receives reassigned benefits from 2 practitioners
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

3723 Nostrand Ave
Brooklyn, NY 11235
Phone (718) 646-6200

Practitioners & affiliated clinicians

Practitioners 3

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": "1160179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350000000000",
    "number": "1720175938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3723 NOSTRAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112351907",
            "telephone_number": "718-646-6200",
            "fax_number": "718-648-0836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3723 NOSTRAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112351907",
            "telephone_number": "718-646-6200",
            "fax_number": "718-648-0836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VOGUE OPTICAL LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-07",
        "last_updated": "2012-10-12",
        "status": "A",
        "authorized_official_last_name": "YUSIM",
        "authorized_official_first_name": "LEONID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-646-6200",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "008999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01777297",
            "state": "NY"
        }
    ],
    "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 Oct 12, 2012; 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.