Individual provider Active NPI

Simrit Kaur Virk, OD

  • Optometrist
  • Northport, NY
National Provider Identifier
1790398634
Registry record updated Aug 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV009139-01 Issued in NY
Practice address
79 Middleville Rd
Northport, NY 11768-2200
Phone
(631) 261-4400
NPI assigned
Aug 29, 2020
Last updated
Aug 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV009139-01 NY Primary

Addresses

Primary practice location

79 Middleville Rd
Northport, NY 11768-2200

Mailing address

14 Capel Dr
Dix Hills, NY 11746-5803
Phone (516) 232-3210

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Simrit.Virk@va.gov Direct

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
I20220307001296 NY Practitioner - Optometry 6305230475 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV009139-01NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Vision and Contact Lens Services, Inc. Optometrist CurrentSince Feb 22, 2022 Accepting new patients

Locations

160 Walt Whitman Rd
Ste 1021B
Huntington Station, NY 11746
Phone (631) 351-5355

502 Smith Haven Mall
Lake Grove, NY 11755
Phone (631) 257-3036

3070 Bristol Pike
Ste 2-220
Bensalem, PA 19020
Phone 2144971001108

Interoperability endpoints

  • Direct secure messaging: simrit.virk@va.gov

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": "1598659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598659200000",
    "number": "1790398634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 CAPEL DR",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465803",
            "telephone_number": "516-232-3210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 MIDDLEVILLE RD",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117682200",
            "telephone_number": "631-261-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIRK",
        "first_name": "SIMRIT",
        "middle_name": "KAUR",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-29",
        "last_updated": "2020-08-29",
        "certification_date": "2020-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV009139-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Simrit.Virk@va.gov",
            "affiliation": "N",
            "endpointDescription": "Email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "79 Middleville Rd",
            "city": "Northport",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117682200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Northport, NY

Sources for this page

Verify at the official NPI Registry.