Marsh Optical Boutique Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4807 Issued in NY

Legal business name

MARSH OPTICAL BOUTIQUE INC.

Practice address

18012 Union Tpke
Fresh Meadows, NY 11366-1620

Phone

(718) 380-5353

Fax

(718) 380-5396

NPI assigned

May 16, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Wendy Marsh

Title

Owner

Phone

(718) 380-5353

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

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

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kai-May Chen, O.D.

  • Optometrist
  • Fresh Meadows, NY
  • NPI 1194799791
  Medicare reassignment NPD
• Fiza Shuja, OD

  • Optometrist
  • New York, NY
  • NPI 1457775017
  Medicare reassignment NPD
• Robert Arthur Marsh, OPTICIAN

  • Optician
  • Flushing, NY
  • NPI 1265520357
  NPD
• Michael Kakzanov, O.D.

  • Optometrist
  • Forest Hills, NY
  • NPI 1841378510
  NPD (past)

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412035200000",
    "number": "1811104375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18012 UNION TPKE",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661620",
            "telephone_number": "718-380-5353",
            "fax_number": "718-380-5396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18012 UNION TPKE",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661620",
            "telephone_number": "718-380-5353",
            "fax_number": "718-380-5396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARSH OPTICAL BOUTIQUE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2014-09-30",
        "status": "A",
        "authorized_official_last_name": "MARSH",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-380-5353",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "4807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01449467",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jesenia Marin
• Marina SLP PC
• Lori Marinelli-Jansson, M.A.
• Joseph M Marino, DPT
• Rivka Markowitz, O.D.
• Bradley Jay Marsh, DPM
• Ana L Marte
• Giselle Marte
• Marie Kathlyn Marte, NP
• Mayra Martinez Chan

• Optometrist in Fresh Meadows, NY
• Providers in Fresh Meadows, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; 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.