NPIMap

Organization Active NPI

E.L.H. Optical, Inc.

Doing business as Pearle Vision

  • Optician
  • Stony Brook, NY
National Provider Identifier
1871630715
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
006051 Issued in NY
Legal business name
E.L.H. OPTICAL, INC.
Doing business as
Pearle Vision
Practice address
1320 Stony Brook Rd
Suite # 130
Stony Brook, NY 11790-2206
Phone
(631) 751-8200
Fax
(631) 751-8250
NPI assigned
Jan 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

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

Authorized official

Name
Mr. John Vargas, LDO
Title
Manager
Phone
(631) 751-8200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X 006051 NY Primary

Addresses

Primary practice location

1320 Stony Brook Rd
Suite # 130
Stony Brook, NY 11790-2206

Mailing address

1320 Stony Brook Rd
Suite # 130
Stony Brook, NY 11790-2206
Phone (631) 751-8200

Other names 1

  • Pearle Vision Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120418000701 NY Part B Supplier - Clinic/Group Practice 6406017474 Receives reassigned benefits from 2 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bohemia, NY; East Meadow, NY; Flushing, NY; Massapequa, NY; New Hyde Park, NY; Stony Brook, NY; Syosset, NY

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Dr Michael C Hans OD PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2365 Hempstead Tpke
East Meadow, NY 11554
Phone (516) 796-3800

1320 Stony Brook Rd
Ste 130
Stony Brook, NY 11790
Phone (631) 751-8200

Practitioners & affiliated clinicians

Practitioners 4

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": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191888000000",
    "number": "1871630715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 STONY BROOK RD",
            "address_2": "SUITE # 130",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902206",
            "telephone_number": "631-751-8200",
            "fax_number": "631-751-8250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 STONY BROOK RD",
            "address_2": "SUITE # 130",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902206",
            "telephone_number": "631-751-8200",
            "fax_number": "631-751-8250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E.L.H. OPTICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-10-09",
        "status": "A",
        "authorized_official_last_name": "VARGAS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "631-751-8200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LDO"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "006051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pearle Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stony Brook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; 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.