Organization Active NPI

Successful Vision Corp

  • Optometrist
  • Pelham, NY
National Provider Identifier
1730617614
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
184913 Issued in NY
Legal business name
SUCCESSFUL VISION CORP
Practice address
106 Fifth Ave
Pelham, NY 10803-1504
Phone
(914) 235-5068
Fax
(914) 636-1317
NPI assigned
May 23, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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

Authorized official

Name
Francis Raymond Depaolo II
Title
Manager
Phone
(914) 235-5068

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 184913 NY Primary

Addresses

Primary practice location

106 Fifth Ave
Pelham, NY 10803-1504

Mailing address

106 Fifth Ave
Pelham, NY 10803-1504
Phone (914) 235-5068

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170830001168 NY Part B Supplier - Clinic/Group Practice 5496028219 Receives reassigned benefits from 1 practitioner
Practice locations: Pelham, NY

National Provider Directory

National Provider Directory

Locations

252 W 79th St
New York, NY 10024
Phone (646) 784-0002

106 Fifth Ave
Pelham, NY 10803
Phone (914) 235-5068

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": "1495497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776816000000",
    "number": "1730617614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 FIFTH AVE",
            "city": "PELHAM",
            "state": "NY",
            "postal_code": "108031504",
            "telephone_number": "914-235-5068",
            "fax_number": "914-636-1317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 FIFTH AVE",
            "city": "PELHAM",
            "state": "NY",
            "postal_code": "108031504",
            "telephone_number": "914-235-5068",
            "fax_number": "914-636-1317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUCCESSFUL VISION CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-23",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A",
        "authorized_official_last_name": "DEPAOLO",
        "authorized_official_first_name": "FRANCIS",
        "authorized_official_middle_name": "RAYMOND",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "914-235-5068",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "184913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pelham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2026; 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.