Organization Active NPI

SJB Optical Corp.

  • Optician
  • Whitestone, NY
National Provider Identifier
1861697195
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
5221 Issued in NY
Legal business name
SJB OPTICAL CORP.
Practice address
15369 Cross Island Pkwy
Whitestone Shopping Center
Whitestone, NY 11357-2648
Phone
(718) 767-6379
NPI assigned
Jun 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Authorized official

Name
Mr. Steven J. BenjaminNPI 1578767968
Title
Optician
Phone
(718) 767-6379

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
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X 5221 NY Primary

Addresses

Primary practice location

15369 Cross Island Pkwy
Whitestone Shopping Center
Whitestone, NY 11357-2648

Mailing address

15369 Cross Island Pkwy
Whitestone Shopping Center
Whitestone, NY 11357-2648
Phone (718) 767-6379

Other names 1

  • Optometrics Eye Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070928000708 NY Part B Supplier - Clinic/Group Practice 8628163086 Receives reassigned benefits from 1 practitioner
Practice locations: Whitestone, NY
O20100930066615 NY DME Supplier - Optician 8628163086 Practice locations: Whitestone, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
SJB Optical Corp15369 Cross Island Pkwy, Whitestone, NY 11357-2648(718) 767-6379 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Sep 1, 2001

National Provider Directory

National Provider Directory

Locations

15369 Cross Island Pkwy
Whitestone, NY 11357
Phone (718) 767-6379

Practitioners & affiliated clinicians

Practitioners 2

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": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205712000000",
    "number": "1861697195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15369 CROSS ISLAND PKWY",
            "address_2": "WHITESTONE SHOPPING CENTER",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113572648",
            "telephone_number": "718-767-6379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15369 CROSS ISLAND PKWY",
            "address_2": "WHITESTONE SHOPPING CENTER",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113572648",
            "telephone_number": "718-767-6379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SJB OPTICAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2008-03-17",
        "status": "A",
        "authorized_official_last_name": "BENJAMIN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OPTICIAN",
        "authorized_official_telephone_number": "718-767-6379",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "5221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optometrics Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Whitestone, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.