Organization Active NPI

Holbrook Optics Inc

Doing business as Maz Optical

  • Optometrist
  • Holbrook, NY
National Provider Identifier
1801489968
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
HOLBROOK OPTICS INC
Doing business as
Maz Optical
Practice address
971 Main St Ste D
Holbrook, NY 11741-1609
Phone
(631) 471-0600
NPI assigned
Feb 18, 2021
Last updated
Jun 3, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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

Authorized official

Name
Patricia S Eddy
Title
Billing Manager
Phone
(517) 231-4086

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

971 Main St Ste D
Holbrook, NY 11741-1609

Mailing address

971D Main St # D
Holbrook, NY 11741-1605
Phone (631) 471-0600

Other names 1

  • Maz Optical Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210419000072 NY Part B Supplier - Clinic/Group Practice 1153739826 Receives reassigned benefits from 6 practitioners
Practice locations: Holbrook, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1613606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622678400000",
    "number": "1801489968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "971D MAIN ST # D",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117411605",
            "telephone_number": "631-471-0600",
            "fax_number": "631-684-9906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 MAIN ST STE D",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117411609",
            "telephone_number": "631-471-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLBROOK OPTICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-18",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A",
        "authorized_official_last_name": "EDDY",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "517-231-4086"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maz Optical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Maz Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Holbrook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; 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.