Organization Active NPI

Ioptik, Inc.

  • Optometrist
  • Philadelphia, PA
National Provider Identifier
1780043794
Registry record updated Feb 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG002492 Issued in PA
Legal business name
IOPTIK, INC.
Practice address
8354 Bustleton Ave
Philadelphia, PA 19152-1909
Phone
(215) 745-2020
Fax
(215) 745-2021
NPI assigned
Feb 18, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2016

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

Authorized official

Name
Vlad Bagdasarian
Title
Owner
Phone
(215) 745-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OEG002492 PA Primary

Addresses

Primary practice location

8354 Bustleton Ave
Philadelphia, PA 19152-1909

Mailing address

8354 Bustleton Ave
Philadelphia, PA 19152-1909
Phone (215) 745-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160330000127 PA Part B Supplier - Clinic/Group Practice 0042517492 Receives reassigned benefits from 1 practitioner
Practice locations: Philadelphia, PA
O20161018002900 PA DME Supplier - Physician - Optometrist 0042517492 Practice locations: Philadelphia, PA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Ioptik Inc8354 Bustleton Ave, Philadelphia, PA 19152-1909(215) 745-2020 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Mar 17, 2016

National Provider Directory

National Provider Directory

Locations

8354 Bustleton Ave
Philadelphia, PA 19152
Phone (215) 745-2020

Practitioners & affiliated clinicians

Practitioners 1

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": "1455753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455753600000",
    "number": "1780043794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8354 BUSTLETON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191521909",
            "telephone_number": "215-745-2020",
            "fax_number": "215-745-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8354 BUSTLETON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191521909",
            "telephone_number": "215-745-2020",
            "fax_number": "215-745-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOPTIK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-18",
        "last_updated": "2016-02-18",
        "status": "A",
        "authorized_official_last_name": "BAGDASARIAN",
        "authorized_official_first_name": "VLAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-745-2020"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.