Organization Active NPI

Green Acres Vistasite Inc

  • Optometrist
  • Valley Stream, NY
National Provider Identifier
1831442995
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV006117-1 Issued in NY
Legal business name
GREEN ACRES VISTASITE INC
Practice address
1088 Green Acres Mall # 118
Valley Stream, NY 11581-1535
Phone
(516) 568-2010
Fax
(516) 568-2060
NPI assigned
Oct 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Authorized official

Name
Michael OrloffNPI 1336392885
Title
Owner
Phone
(914) 523-4295

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X TUV006117-1 NY Primary

Addresses

Primary practice location

1088 Green Acres Mall # 118
Valley Stream, NY 11581-1535

Mailing address

1088 Green Acres Mall # 118
Valley Stream, NY 11581-1535
Phone (718) 547-2020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130326000207 NY Part B Supplier - Clinic/Group Practice 3072758994 Receives reassigned benefits from 4 practitioners
Practice locations: Valley Stream, NY

National Provider Directory

National Provider Directory

Locations

1088 Green Acres Mall
#M
Valley Stream, NY 11581

1088 Green Acres Mall
#118
Valley Stream, NY 11581
Phone (516) 568-2010

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746576000000",
    "number": "1831442995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1088 GREEN ACRES MALL # 118",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811535",
            "telephone_number": "718-547-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1088 GREEN ACRES MALL # 118",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811535",
            "telephone_number": "516-568-2010",
            "fax_number": "516-568-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN ACRES VISTASITE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-25",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A",
        "authorized_official_last_name": "ORLOFF",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "914-523-4295"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006117-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; 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.