Individual provider Active NPI

Jessy James Vaidhyan, O.D

  • Optometrist
  • New York, NY
National Provider Identifier
1750526091
Registry record updated May 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV007380-1 Issued in NY
Practice address
50 E 42ND St
New York, NY 10017-5405
Phone
(212) 697-1838
Fax
(212) 697-0323
NPI assigned
Dec 15, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4704 MA
Optometrist 152W00000X TUV007380-1 NY Primary

Addresses

Primary practice location

50 E 42ND St
New York, NY 10017-5405

Mailing address

114 Hillwood LN
Plainview, NY 11803-3120
Phone (617) 512-0566

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
I20130212000495 NY Practitioner - Optometry 5092969477 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704MAMDMental Health Counselor
007380NYMDRegistered Dietitian
TUV007380-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Empire Vision Center Inc Optometrist CurrentSince Apr 12, 2018 Accepting new patients
Empire Vision Center, Inc CurrentSince Apr 12, 2018 Accepting new patients

Locations

600 Old Country Rd
Garden City, NY 11530
Phone (516) 745-6564

560 Troy Schenectady Rd
#7
Latham, NY 12110
Phone (518) 783-0090

1930 South Rd
#105
Poughkeepsie, NY 12601
Phone (845) 298-3200

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1229299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241395200000",
    "number": "1750526091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 HILLWOOD LN",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118033120",
            "telephone_number": "617-512-0566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 E 42ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100175405",
            "telephone_number": "212-697-1838",
            "fax_number": "212-697-0323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAIDHYAN",
        "first_name": "JESSY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-15",
        "last_updated": "2009-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4704",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007380-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.