Organization Active NPI

Brooklyn Eye Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Brooklyn, NY
National Provider Identifier
1730180084
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
BROOKLYN EYE SURGERY CENTER LLC
Practice address
1301 Avenue J
Brooklyn, NY 11230-3605
Phone
(718) 645-0600
Fax
(718) 692-4456
NPI assigned
Aug 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Authorized official

Name
Dr. Leonard Bley, M.D.
Title
Managing Director
Phone
(718) 645-0600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

1301 Avenue J
Brooklyn, NY 11230-3605

Mailing address

1301 Avenue J
Brooklyn, NY 11230-3605
Phone (718) 645-0600

Other identifiers 1

IdentifierTypeStateIssuer
01621232MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100407000000 NY Part B Supplier - Ambulatory Surgical Center 5597891101 Practice locations: Brooklyn, NY

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Brooklyn Eye Surgery Center LLCCCN 33C0001001
Medicare certification status
ActiveFrom the Provider of Services file

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0986766Brooklyn Eye Surgery Center1301 Avenue J, Brooklyn, NY 11230Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603843200000",
    "number": "1730180084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 AVENUE J",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112303605",
            "telephone_number": "718-645-0600",
            "fax_number": "718-692-4456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 AVENUE J",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112303605",
            "telephone_number": "718-645-0600",
            "fax_number": "718-692-4456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKLYN EYE SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A",
        "authorized_official_last_name": "BLEY",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "718-645-0600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01621232",
            "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 28, 2020; 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.