Individual provider Active NPI

Sharona Sassouni, DOCTOR OF OPTOMETRY

  • Optometrist
  • Roslyn Heights, NY
National Provider Identifier
1841776317
Registry record updated Jul 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
008761 Issued in NY
Practice address
360 Willis Ave
Roslyn Heights, NY 11577-2322
Phone
(516) 568-5930
NPI assigned
Jul 17, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 008761 NY Primary

Addresses

Primary practice location

360 Willis Ave
Roslyn Heights, NY 11577-2322

Mailing address

56 Villa St
Roslyn Heights, NY 11577-1950
Phone (516) 582-2329

Other practice location 1

140 Hillside Ave Fl 1
New Hyde Park, NY 11040-2508
Phone (516) 502-9395

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
I20190509001554 NY Practitioner - Optometry 6901149103 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Mar 31, 2019 Accepting new patients
North Shore - Lij Medical PC CurrentSince Mar 31, 2019 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

17660 Union Tpke
Ste 110
Fresh Meadows, NY 11366
Phone (718) 460-1200

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Organizations & group practices 2

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": "1531785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531785600000",
    "number": "1841776317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 VILLA ST",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115771950",
            "telephone_number": "516-582-2329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 WILLIS AVE",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115772322",
            "telephone_number": "516-568-5930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 Hillside Ave Fl 1",
            "address_purpose": "LOCATION",
            "city": "New Hyde Park",
            "state": "NY",
            "postal_code": "110402508",
            "country_code": "US",
            "telephone_number": "516-502-9395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SASSOUNI",
        "first_name": "SHARONA",
        "name_prefix": "Dr.",
        "credential": "DOCTOR OF OPTOMETRY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-17",
        "last_updated": "2018-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "008761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn Heights, NY

Sources for this page

Verify at the official NPI Registry.