Active NPI
Kelly Chajka, O.D., M.S.
- Optometrist
- New York, NY
National Provider Identifier
1740569623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TUV007768
- Practice address
- 33 W 42ND St
New York, NY 10036-8005 - Phone
- (212) 938-5836
- NPI assigned
- Aug 10, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | TUV007768 | NY | Primary |
Addresses
Primary practice location
33 W 42ND St
New York, NY 10036-8005
Mailing address
33 W 42ND St
New York, NY 10036-8005
Phone (212) 938-5836
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 13, 2024 through Jun 13, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TUV007768 | NY | MD | Optometrist |
| 007768 | NY | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312934400000",
"number": "1740569623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 W 42ND ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100368005",
"telephone_number": "212-938-5836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33 W 42ND ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100368005",
"telephone_number": "212-938-5836"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAJKA",
"first_name": "KELLY",
"name_prefix": "Dr.",
"credential": "O.D., M.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-10",
"last_updated": "2011-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "TUV007768",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.