Individual provider Active NPI

Yan Kotlyar, LICENSED OPTICIAN

  • Optician
  • Brooklyn, NY
National Provider Identifier
1831456623
Registry record updated Apr 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
7361 Issued in NY
Practice address
6 Newkirk PLZ
Brooklyn, NY 11226-6526
Phone
(718) 421-7209
Fax
(718) 421-7209
NPI assigned
Apr 18, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 7361 NY Primary

Addresses

Primary practice location

6 Newkirk PLZ
Brooklyn, NY 11226-6526

Mailing address

6 Newkirk PLZ
Brooklyn, NY 11226-6526
Phone (718) 421-7209

Other identifiers 1

IdentifierTypeStateIssuer
1740385194MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7361NYMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Veyana Optical Optician Past Accepting new patients

Organizations & group practices 1

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": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334707200000",
    "number": "1831456623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 NEWKIRK PLZ",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112266526",
            "telephone_number": "718-421-7209",
            "fax_number": "718-421-7209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 NEWKIRK PLZ",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112266526",
            "telephone_number": "718-421-7209",
            "fax_number": "718-421-7209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTLYAR",
        "first_name": "YAN",
        "name_prefix": "Mr.",
        "credential": "LICENSED OPTICIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-18",
        "last_updated": "2012-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "7361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740385194",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.