NPIMap

Organization Active NPI

Indigo Optical Inc.

  • Optometrist
  • Astoria, NY
National Provider Identifier
1851678809
Registry record updated Nov 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV007499 Issued in NY
Legal business name
INDIGO OPTICAL INC.
Practice address
3241 Steinway St Ste a
Astoria, NY 11103-4036
Phone
(347) 808-9155
NPI assigned
Nov 4, 2011
Last updated
Nov 4, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2011

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

Authorized official

Name
Mr. Robert YusupovNPI 1366728396
Title
Owner/Optician
Phone
(347) 808-9155

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X TUV007499 NY Primary

Addresses

Primary practice location

3241 Steinway St Ste a
Astoria, NY 11103-4036

Mailing address

3241 Steinway St Ste a
Astoria, NY 11103-4036

National Provider Directory

National Provider Directory

Locations

3241 Steinway St
Ste A
Astoria, NY 11103
Phone (347) 808-9155

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1320364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320364800000",
    "number": "1851678809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3241 STEINWAY ST STE A",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111034036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3241 STEINWAY ST STE A",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111034036",
            "telephone_number": "347-808-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIGO OPTICAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-04",
        "last_updated": "2011-11-04",
        "status": "A",
        "authorized_official_last_name": "YUSUPOV",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER/OPTICIAN",
        "authorized_official_telephone_number": "347-808-9155",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; 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.