Individual provider Active NPI

Mijin Sohn, O.D.

  • Optometrist
  • New York, NY
National Provider Identifier
1881609246
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV006961 Issued in NY
Practice address
62 Grand Central Terminal
New York, NY 10017-5622
Phone
(212) 599-1221
Fax
(212) 687-5414
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV006961 NY Primary

Addresses

Primary practice location

62 Grand Central Terminal
New York, NY 10017-5622

Mailing address

369 Madison Ave
New York, NY 10017-3108
Phone (212) 599-1220

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
I20070222000567 NY Practitioner - Optometry 8921100975 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV006961NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Krystal Klear Optical Inc. Optometrist CurrentSince Dec 1, 2022 Accepting new patients
Grand Central Optical Co Inc Optometrist CurrentSince Nov 18, 2011 Accepting new patients
Epic Medical Group,Inc Past Accepting new patients

Locations

62 Grand Central Terminal
New York, NY 10017
Phone (212) 599-1220

342 Madison Ave
New York, NY 10173
Phone (212) 599-1220

369 Madison Ave
New York, NY 10017
Phone (212) 599-1220

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7032/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881609246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "369 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100173108",
            "telephone_number": "212-599-1220",
            "fax_number": "212-687-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 GRAND CENTRAL TERMINAL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100175622",
            "telephone_number": "212-599-1221",
            "fax_number": "212-687-5414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOHN",
        "first_name": "MIJIN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.