Oleg Lisitsyn, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

006388 Issued in NY

Practice address

731 Lydig Ave
Bronx, NY 10462-2103

Phone

(718) 829-2160

Fax

(718) 829-9502

NPI assigned

May 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 12

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

State University of New York - State College Optometry, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bronx Vistasite Eyecare IncGroup PAC ID 7315129210, 2 clinicians

Bronx Vista Inc.Group PAC ID 3971805151, 7 clinicians

Pelham Parkway Vision Center IncGroup PAC ID 6305938218, 4 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.

• Bronx Vista Inc

  • Optometrist
  • Bronx, NY
  • NPI 1689044067
  Medicare reassignment Care Compare group NPD Authorized official
• Pelham Parkway Vision Center Inc

  • Vision Therapy Optometrist
  • Bronx, NY
  • NPI 1740402205
  Medicare reassignment Care Compare group NPD Authorized official
• Bronx Vistasite Eyecare Inc

  • Optometrist
  • Bronx, NY
  • NPI 1114244563
  Medicare reassignment Care Compare group NPD
• Bronx Vistasite Eyecare

  • Eyewear Supplier
  • Bronx, NY
  • NPI 1518355767
  NPD (past)
• Lydig Optical Lab

  • Optician
  • Bronx, NY
  • NPI 1568559771
  NPD (past)
• Medical Network Services PC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1871507731
  NPD (past)
• Radiology Medical Associates PC

  • Diagnostic Radiology Physician
  • Rego Park, NY
  • NPI 1740536044
  NPD (past)

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1811948052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 ROME AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103044317",
            "telephone_number": "718-442-1981",
            "fax_number": "718-265-9219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 LYDIG AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104622103",
            "telephone_number": "718-829-2160",
            "fax_number": "718-829-9502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISITSYN",
        "first_name": "OLEG",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "006388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7894651",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "12291667",
            "identifier": "12291667",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "9681151",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02207129",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3693940",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "52917",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2806825",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "204824P",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEATHCARE",
            "identifier": "2420108",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "4C8453",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8127719",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "C172A1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ydalis M Liriano, PNP
• Martina Lirios-Siciliano, MD
• Robert Lis, MD
• Liscio Pharma Inc
• Liscio Pharmacy Corp
• Agata Lisok
• Danielle Rebecca Liss, M.A., CCC-SLP
• Elena Lissina, DDS, PHD
• Kara Lissy, LMSW
• Julie A List, LCSW

• Optometrist in Bronx, NY
• Providers in Bronx, 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 6, 2021; 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.