Individual provider Active NPI

Viktoriya Gutkevich, O.D.

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1831171743
Registry record updated Nov 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV006614 Issued in NY
Practice address
48 Graham Ave
Brooklyn, NY 11206-4002
Phone
(718) 388-7400
NPI assigned
Nov 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV006614 NY Primary

Addresses

Primary practice location

48 Graham Ave
Brooklyn, NY 11206-4002

Mailing address

105 Kings Hwy
Apt 3a
Brooklyn, NY 11214-1525
Phone (718) 513-4052

Other identifiers 1

IdentifierTypeStateIssuer
02350058MedicaidNY

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
I20040420000012 NY Practitioner - Optometry 3375538192 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Focus Medical Ny PLLCGroup PAC ID 0446799050, 4 clinicians
Optiglaz Inc.Group PAC ID 2860381688, 2 clinicians

Practice addresses (Care Compare)

48 Graham Ave
Brooklyn, NY 11206-4002
Phone (718) 388-7400

720 Brighton Beach Ave
Brooklyn, NY 11235-6412
Phone (718) 891-6400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006614NYMDRegistered Dietitian
TUV006614NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne Tabachnick, OD PC Optometrist CurrentSince Oct 21, 1993 Accepting new patients
Wayne Tabachnick OD PC Optometrist Current Accepting new patients
Optiglaz Inc. CurrentSince Oct 25, 1993 Accepting new patients
Focus Medical Ny, PLLC Optometrist CurrentSince Jul 20, 2024 Accepting new patients
V&R Optometric Associates Optometrist Past Accepting new patients
Kingsboro Optometric PC Optometrist PastSince Oct 25, 1993 Accepting new patients

Locations

48 Graham Ave
Brooklyn, NY 11206
Phone (718) 388-7400

720 Brighton Beach Ave
Brooklyn, NY 11235
Phone (718) 891-6400

7501 Paragon Rd
Ste 201
Dayton, OH 45459

Organizations & group practices 6

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": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385078400000",
    "number": "1831171743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 KINGS HWY",
            "address_2": "APT 3A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112141525",
            "telephone_number": "718-513-4052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 GRAHAM AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112064002",
            "telephone_number": "718-388-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTKEVICH",
        "first_name": "VIKTORIYA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-16",
        "last_updated": "2013-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02350058",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.