Individual provider Active NPI

Jason Manohar, OD

  • Optometrist
  • Riverhead, NY
National Provider Identifier
1720825532
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
009980 Issued in NY
Practice address
1224 Ostrander Ave
Riverhead, NY 11901
Phone
(631) 727-2858
NPI assigned
Jul 9, 2024
Last updated
Jul 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 009980 NY Primary

Addresses

Primary practice location

1224 Ostrander Ave
Riverhead, NY 11901

Mailing address

1224 Ostrander Ave Riverhead
Riverhead, NY 11901

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241014001982 NY Practitioner - Optometry 6709318942 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sound Vision Care, IncGroup PAC ID 5496801417, 6 clinicians
SVC of Riverhead LLCGroup PAC ID 8921437500, 5 clinicians
SVC of Fresh Meadows LLCGroup PAC ID 0648684001, 2 clinicians

Practice addresses (Care Compare)

1224 Ostrander Ave
Riverhead, NY 11901-2109
Phone (631) 727-2858

6130 A 190TH St
Fresh Meadows, NY 11365-2721
Phone (771) 845-4848

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009980NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Fresh Eyes Inc Optometrist CurrentSince Jul 19, 2024 Accepting new patients
Sound Vision Care, Inc. Optometrist CurrentSince Jul 19, 2024 Accepting new patients
SVC of Forest Hills One LLC Optometrist CurrentSince Jul 19, 2024 Accepting new patients
SVC of Riverhead LLC Optometrist CurrentSince Jul 19, 2024 Accepting new patients
SVC of Fresh Meadows LLC Optometrist CurrentSince Jul 19, 2024 Accepting new patients

Locations

7119 Austin St
Forest Hills, NY 11375
Phone (718) 268-7709

6130A 190th St
Fresh Meadows, NY 11365
Phone (718) 454-8484

1224 Ostrander Ave
Riverhead, NY 11901
Phone (631) 727-2858

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1720483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1720825532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 OSTRANDER AVE RIVERHEAD",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "11901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 OSTRANDER AVE",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "11901",
            "telephone_number": "631-727-2858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANOHAR",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-09",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "009980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

Verify at the official NPI Registry.