Organization Active NPI

Luxury Vision Center Inc

  • Eyewear Supplier
  • Brooklyn, NY
National Provider Identifier
1720770555
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
LUXURY VISION CENTER INC
Practice address
1125 Liberty Ave
Brooklyn, NY 11208-3310
Phone
(917) 471-9505
NPI assigned
May 22, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2023

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

Authorized official

Name
Larisa MirakovaNPI 1841971306
Title
Optician/Owner
Phone
(917) 471-9505

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

1125 Liberty Ave
Brooklyn, NY 11208-3310

Mailing address

1125 Liberty Ave
Brooklyn, NY 11208-3310
Phone (917) 471-9505

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250409000414 NY Part B Supplier - Clinic/Group Practice 0547784787 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

1125 Liberty Ave
Brooklyn, NY 11208
Phone (718) 235-7900

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": "1684713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684713600000",
    "number": "1720770555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 LIBERTY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112083310",
            "telephone_number": "917-471-9505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 LIBERTY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112083310",
            "telephone_number": "917-471-9505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUXURY VISION CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A",
        "authorized_official_last_name": "MIRAKOVA",
        "authorized_official_first_name": "LARISA",
        "authorized_official_title_or_position": "OPTICIAN/OWNER",
        "authorized_official_telephone_number": "917-471-9505"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 22, 2023; 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.