Active NPI
Tan & Mar Optometry
Doing business as Northport Eye Care
- Optometrist
- Northport, NY
National Provider Identifier
1770973968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- NY TUV 7209
- Legal business name
- TAN & MAR OPTOMETRY
- Doing business as
- Northport Eye Care
- Practice address
- 834 Fort Salonga Rd
Suite D
Northport, NY 11768-3157 - Phone
- (631) 757-4440
- Fax
- (631) 757-4593
- NPI assigned
- Jan 27, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Grace Tan, O.D.
- Title
- Member
- Phone
- (631) 757-4440
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | NY TUV 7209 | NY | Primary |
Addresses
Primary practice location
834 Fort Salonga Rd
Suite D
Northport, NY 11768-3157
Mailing address
834 Fort Salonga Rd
Suite D
Northport, NY 11768-3157
Phone (631) 757-4440
Other names 1
- Northport Eye Care
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
834 Fort Salonga Rd
Ste D
Northport, NY 11768
Phone (631) 757-4440
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- Northport, NY
- NPI 1770776197
-
- Optometrist
- Northport, NY
- NPI 1790965101
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422316800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1425427200000",
"number": "1770973968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "834 FORT SALONGA RD",
"address_2": "SUITE D",
"city": "NORTHPORT",
"state": "NY",
"postal_code": "117683157",
"telephone_number": "631-757-4440",
"fax_number": "631-757-4593"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "834 FORT SALONGA RD",
"address_2": "SUITE D",
"city": "NORTHPORT",
"state": "NY",
"postal_code": "117683157",
"telephone_number": "631-757-4440",
"fax_number": "631-757-4593"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TAN & MAR OPTOMETRY",
"organizational_subpart": "NO",
"enumeration_date": "2015-01-27",
"last_updated": "2015-03-04",
"status": "A",
"authorized_official_last_name": "TAN",
"authorized_official_first_name": "GRACE",
"authorized_official_title_or_position": "MEMBER",
"authorized_official_telephone_number": "631-757-4440",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "O.D."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "NY",
"license": "NY TUV 7209",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Northport Eye Care",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Northport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2015; 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.