Park Slope Eye, Optometric PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

006867 Issued in NY

Legal business name

PARK SLOPE EYE, OPTOMETRIC PLLC

Practice address

682 Union St
Brooklyn, NY 11215-2047

Phone

(347) 560-8393

Fax

(888) 850-6294

NPI assigned

Mar 20, 2008

Last updated

Sep 15, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Justin Bazan, ODNPI 1235343559

Title

Owner

Phone

(646) 496-7365

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 4

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.

• Justin Bazan, OD

  • Optometrist
  • Brooklyn, NY
  • NPI 1235343559
  Medicare reassignment Care Compare group Authorized official
• Derek Lin, OD

  • Optometrist
  • Brooklyn, NY
  • NPI 1245963248
  Medicare reassignment Care Compare group NPD
• Brandon B Or, OD

  • Optometrist
  • Brooklyn, NY
  • NPI 1346734845
  NPD (past)
• Katelyn Rogerson, O.D.

  • Optometrist
  • Dobbs Ferry, NY
  • NPI 1275866014
  NPD (past)

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

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789430400000",
    "number": "1750552501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "682 UNION ST APT 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112151161",
            "telephone_number": "347-560-8393",
            "fax_number": "888-850-6294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "682 UNION ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112152047",
            "telephone_number": "347-560-8393",
            "fax_number": "888-850-6294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK SLOPE EYE, OPTOMETRIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-20",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A",
        "authorized_official_last_name": "BAZAN",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "646-496-7365",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "006867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Park Slope Family Dentistry PC
• Park Slope Gastroenterology PLLC
• Park Slope Hematology Oncology, P.C.
• Park Slope Integrative Medicine PLCC
• Park Slope Kids Dental Care

• Optometrist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.