Individual provider Active NPI

Julie Shin

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1801469820
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
009380 Issued in NY
Practice address
208 Flatbush Ave
Brooklyn, NY 11217-2116
Phone
(718) 514-6234
NPI assigned
Jul 19, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 009380 NY Primary

Addresses

Primary practice location

208 Flatbush Ave
Brooklyn, NY 11217-2116

Mailing address

18 Rockingham CT
Germantown, MD 20874-2223

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
I20231012001629 NY Practitioner - Optometry 8022463900 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009380NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Heights Optical Inc Optometrist CurrentSince Sep 9, 2023 Accepting new patients
Astoria Vision Center Inc Optometrist CurrentSince Sep 9, 2023 Accepting new patients
Chinatown Optical Inc. PastSince Jul 1, 2021 Accepting new patients

Locations

3620 Broadway
Astoria, NY 11106
Phone (718) 204-2007

8325 37th Ave
Jackson Hts, NY 11372
Phone (718) 246-2725

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1801469820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 ROCKINGHAM CT",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208742223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 FLATBUSH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112172116",
            "telephone_number": "718-514-6234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "JULIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-19",
        "last_updated": "2024-03-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "009380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.