Individual provider Active NPI

Sevada Hakobyan, OD

  • Optometrist
  • Jackson Heights, NY
National Provider Identifier
1881236669
Registry record updated Oct 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
009065 Issued in NY
Practice address
3457 82ND St Ste 1F
Jackson Heights, NY 11372-2930
Phone
(718) 446-8100
NPI assigned
Oct 13, 2019
Last updated
Oct 13, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 009065 NY Primary

Addresses

Primary practice location

3457 82ND St Ste 1F
Jackson Heights, NY 11372-2930

Mailing address

3410 84TH St Apt H2
Jackson Heights, NY 11372-3126
Phone (216) 571-5933

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200109000259 NY Practitioner - Optometry 1557796109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Visual Ophthalmology Services PCGroup PAC ID 5890076855, 4 clinicians

Practice addresses (Care Compare)

4207 30TH Ave
Astoria, NY 11103-2910
Phone (718) 204-6667

5548 96TH St
Corona, NY 11368-3009
Phone (718) 271-4472

6240 Forest Ave
Ridgewood, NY 11385-1929
Phone (718) 418-0100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009065NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Visual Ophthalmology Services, PC CurrentSince Dec 2, 2019 Accepting new patients

Locations

4207 30th Ave
Long Island City, NY 11103
Phone (718) 204-6667

5629 Metropolitan Ave
Ridgewood, NY 11385
Phone (718) 418-0300

6240 Forest Ave
Ridgewood, NY 11385
Phone (718) 418-0100

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1570924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570924800000",
    "number": "1881236669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 84TH ST APT H2",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113723126",
            "telephone_number": "216-571-5933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3457 82ND ST STE 1F",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113722930",
            "telephone_number": "718-446-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAKOBYAN",
        "first_name": "SEVADA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-13",
        "last_updated": "2019-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "009065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson Heights, NY

Sources for this page

Verify at the official NPI Registry.