Organization Active NPI

Sutphin Optometry PC

Doing business as Sutphin Eye Care

  • Optometrist
  • Jamaica, NY
National Provider Identifier
1760554042
Registry record updated Aug 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
SUTPHIN OPTOMETRY PC
Doing business as
Sutphin Eye Care
Practice address
8914 Sutphin Blvd
Jamaica, NY 11435-3715
Phone
(718) 739-8939
Fax
(718) 739-2755
NPI assigned
Nov 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2013

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

Authorized official

Name
Dr. Farshad Haiimpour, ODNPI 1326190687
Title
Doctor
Phone
(718) 739-8939

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X NY Primary

Addresses

Primary practice location

8914 Sutphin Blvd
Jamaica, NY 11435-3715

Mailing address

8914 Sutphin Blvd
Jamaica, NY 11435-3715
Phone (718) 739-8939

Other identifiers 2

IdentifierTypeStateIssuer
76754121OtherNYAETNA
P2141131OtherNYOXFORD

Other names 1

  • Sutphin Eye Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080903000354 NY Part B Supplier - Clinic/Group Practice 4688740350 Receives reassigned benefits from 1 practitioner
Practice locations: Jamaica, NY

National Provider Directory

National Provider Directory

Locations

8902 Sutphin Blvd
Jamaica, NY 11435
Phone (718) 739-8939

8914 Sutphin Blvd
Jamaica, NY 11435
Phone (718) 739-8939

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": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377734400000",
    "number": "1760554042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8914 SUTPHIN BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114353715",
            "telephone_number": "718-739-8939",
            "fax_number": "718-739-2755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8914 SUTPHIN BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114353715",
            "telephone_number": "718-739-8939",
            "fax_number": "718-739-2755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTPHIN OPTOMETRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2013-08-29",
        "status": "A",
        "authorized_official_last_name": "HAIIMPOUR",
        "authorized_official_first_name": "FARSHAD",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "718-739-8939",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "76754121",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2141131",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sutphin Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2013; 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.