Theresa Rostkowski, O.D., M.S.W., M.A.

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV005138 Issued in NY

Practice address

445 5TH Ave
Apartment 21B
New York, NY 10016-0109

Phone

(212) 679-6647

Fax

(212) 679-6647

NPI assigned

Oct 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Dr. Theresa Rostkowski Tanzil Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Pearle Vision Inc

  • Eyewear Supplier
  • Fairview Heights, IL
  • NPI 1982744033
  NPD (past)

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267747200000",
    "number": "1841380748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 5TH AVE",
            "address_2": "APARTMENT 21B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100160133",
            "telephone_number": "212-679-6647",
            "fax_number": "212-679-6647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 5TH AVE",
            "address_2": "APARTMENT 21B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100160109",
            "telephone_number": "212-679-6647",
            "fax_number": "212-679-6647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSTKOWSKI",
        "first_name": "THERESA",
        "name_prefix": "Dr.",
        "credential": "O.D., M.S.W., M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2010-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "029620",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV005138",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "3610",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "TANZIL",
            "middle_name": "ROSTKOWSKI",
            "prefix": "DR.",
            "credential": "O.D., M.S.W., M.A.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Amy Rost, DO
• Carol Rost
• Jonathan Bradshaw Rost, MD
• Sara Rostami, MD
• Sara Kate Rostanski, MD
• Karen Laurie Roston, DPS OTR/L
• Rostovsky Medical Practice P.C.
• Anton Rostovsky, M.D.
• Robert Oscar Roswell, MD
• Rosy Husni Nutrition PLLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2010; 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.