Organization Active NPI

Eyeworld LTD

  • Optometrist
  • Freeport, NY
National Provider Identifier
1740359983
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV004726-1 Issued in NY
Legal business name
EYEWORLD LTD
Doing business as
EYEWORLD OPTICAL
Practice address
185 W Merrick Rd
Freeport, NY 11520-3712
Phone
(516) 867-1213
Fax
(516) 867-1214
NPI assigned
Nov 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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

Authorized official

Name
Mr. Paul L. Heller, OPTICIANNPI 1720012891
Title
Secretary
Phone
(516) 867-1213

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X TUV004726-1 NY Primary
Durable Medical Equipment & Medical Supplies 332B00000X 4715 NY

Addresses

Primary practice location

185 W Merrick Rd
Freeport, NY 11520-3712

Mailing address

185 W Merrick Rd
Freeport, NY 11520-3712
Phone (516) 867-1213

Other identifiers 1

IdentifierTypeStateIssuer
00847645MedicaidNY

Other names 1

  • EYEWORLD OPTICAL Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070813000434 NY Part B Supplier - Clinic/Group Practice 4880795236 Receives reassigned benefits from 1 practitioner
Practice locations: Freeport, NY

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.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1740359983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 W MERRICK RD",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115203712",
            "telephone_number": "516-867-1213",
            "fax_number": "516-867-1214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 W MERRICK RD",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115203712",
            "telephone_number": "516-867-1213",
            "fax_number": "516-867-1214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYEWORLD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "HELLER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "516-867-1213",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OPTICIAN"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV004726-1",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "4715",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00847645",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EYEWORLD OPTICAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Freeport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; 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.