Organization Active NPI

Paul Kritikos MD Facs PC

  • Ophthalmology Physician
  • New Hyde Park, NY
National Provider Identifier
1861763229
Registry record updated Jan 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
189401 Issued in NY
Legal business name
PAUL KRITIKOS MD FACS PC
Practice address
1300 Union Tpke Ste 105
New Hyde Park, NY 11040-1759
Phone
(516) 326-2275
Fax
(516) 326-2251
NPI assigned
Jan 17, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2012

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

Authorized official

Name
Paul Kritikos, MDNPI 1033202429
Title
President
Phone
(516) 326-2275

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
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 189401 NY Primary

Addresses

Primary practice location

1300 Union Tpke Ste 105
New Hyde Park, NY 11040-1759

Mailing address

1300 Union Tpke Ste 105
New Hyde Park, NY 11040-1759
Phone (516) 326-2275

Other identifiers 1

IdentifierTypeStateIssuer
00246075MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120306000547 NY Part B Supplier - Clinic/Group Practice 5799944096 Receives reassigned benefits from 1 practitioner
Practice locations: New Hyde Park, NY

National Provider Directory

National Provider Directory

Locations

1300 Union Tpke
Ste 105
New Hyde Park, NY 11040
Phone (516) 326-2275

Practitioners & affiliated clinicians

Practitioners 1

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": "1326758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326758400000",
    "number": "1861763229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 UNION TPKE STE 105",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401759",
            "telephone_number": "516-326-2275",
            "fax_number": "516-326-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 UNION TPKE STE 105",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401759",
            "telephone_number": "516-326-2275",
            "fax_number": "516-326-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL KRITIKOS MD FACS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-17",
        "last_updated": "2012-01-17",
        "status": "A",
        "authorized_official_last_name": "KRITIKOS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-326-2275",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "189401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00246075",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.