Kristina Haidatov, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

008824 Issued in NY

Practice address

21519 73Rd Ave
Oakland Gardens, NY 11364-2928

Phone

(718) 819-8477

Fax

(718) 819-8534

NPI assigned

Jun 28, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Pennsylvania College of Optometry, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Haidatov Optometry PCGroup PAC ID 8224418256, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Haidatov Optometry PC

  • Optometrist
  • Oakland Gardens, NY
  • NPI 1609506328
  Medicare reassignment Care Compare group NPD Authorized official
• Cross Bronx Optical Inc.

  • Optometrist
  • Bronx, NY
  • NPI 1326355355
  Medicare reassignment NPD
• Eye Design Optical LLC

  • Optometrist
  • Bronx, NY
  • NPI 1942761002
  Medicare reassignment NPD
• Super Optical Inc.

  • Optometrist
  • Bronx, NY
  • NPI 1922373000
  Medicare reassignment NPD
• Westchester Optical Inc.

  • Optometrist
  • Bronx, NY
  • NPI 1609004183
  Medicare reassignment NPD
• Family Optical Shoppe Corp

  • Optician
  • Bronx, NY
  • NPI 1912945452
  NPD (past)

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

{
    "created_epoch": "1530144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1811482102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21519 73RD AVE",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "113642928",
            "telephone_number": "718-819-8477",
            "fax_number": "718-819-8534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21519 73RD AVE",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "113642928",
            "telephone_number": "718-819-8477",
            "fax_number": "718-819-8534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIDATOV",
        "first_name": "KRISTINA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-28",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "008824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Howard Gordon, DDS
• Catherine Anne Gretton, MA, CCC-SLP
• Absar Haaris, D.O.
• Sherlin Haghnazari
• Haidatov Optometry PC
• Ofer Haidatov, FNP
• Claire M. Haines, OTR/L
• Farid Hakimzadeh, DDS
• Asim Hameedi
• Eunmi Han

• Optometrist in Oakland Gardens, NY
• Providers in Oakland Gardens, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.