Shalom Holtzberg, OPTICIAN

Primary specialty

OpticianTaxonomy code 156FX1800X

License

0085681 Issued in NY

Practice address

4414 16TH Ave
Brooklyn, NY 11204-1012

Phone

(718) 871-6322

NPI assigned

Aug 10, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

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.

• Optical Lab

  • Optometrist
  • Brooklyn, NY
  • NPI 1700342987
  NPD (past)

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

{
    "created_epoch": "1439164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439164800000",
    "number": "1861878159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4414 16TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11204",
            "telephone_number": "718-871-6322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4414 16TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112041012",
            "telephone_number": "718-871-6322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLTZBERG",
        "first_name": "SHALOM",
        "credential": "OPTICIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-10",
        "last_updated": "2015-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "0085681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diedrich K Holtkamp, MD
• Chava Holtz
• Richard Holtz, P.T
• Chanel Holtzberg, MS ED
• Miriam D Holtzberg, M.S. ADV. CERT.
• Jaime Paul Holtzer, PSY.D
• Tamra Sari Holtzer, PHD
• Lawrence M Holtzin, M.D.
• Lucy Holtzman, MPS/ATR-BC/LCAT
• Melissa Jenna Holuboff, OTR/L

• Optician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Optician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.