Individual provider Active NPI

Katherine Gut, O.D,

  • Corneal and Contact Management Optometrist
  • Brooklyn, NY
National Provider Identifier
1750667929
Registry record updated Nov 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
TUV007771-1 Issued in NY
Practice address
114 Java St
Brooklyn, NY 11222-1644
Phone
(718) 389-9266
NPI assigned
Nov 1, 2011
Last updated
Nov 1, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X TUV007771-1 NY Primary

Addresses

Primary practice location

114 Java St
Brooklyn, NY 11222-1644

Mailing address

114 Java St
Brooklyn, NY 11222-1644
Phone (718) 389-9266

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
I20111216000498 NY Practitioner - Optometry 5193990372 Reassigns benefits to 1 organization
Practice locations: Forest Hills, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV007771-1NYMDCorneal and Contact Management Optometrist
007771NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Q Optical Inc. CurrentSince Jul 1, 2014 Accepting new patients

Locations

10423 Queens Blvd
Forest Hills, NY 11375
Phone (718) 275-2500

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1320105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1750667929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 JAVA ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112221644",
            "telephone_number": "718-389-9266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 JAVA ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112221644",
            "telephone_number": "718-389-9266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUT",
        "first_name": "KATHERINE",
        "credential": "O.D,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-01",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NY",
            "license": "TUV007771-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.