Individual provider Active NPI

Michael Kiselow, O.D.

Corneal and Contact Management Optometrist
Brooklyn, NY

National Provider Identifier

1881673184

Registry record updated Jun 28, 2011

On this page

Key facts
NPPES NPI Registry
Medicare participation
Care Compare profile
National Provider Directory
Organizations & group practices3
NPI Registry JSON
Other providers in Brooklyn, NY
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License: TUV006648-1 Issued in NY
Practice address: 909 Manhattan Ave
Greenpoint Eye Care LLC
Brooklyn, NY 11222-5960
Phone: (718) 389-0333
Fax: (718) 389-0040
NPI assigned: Jan 13, 2006
Last updated: Jun 28, 2011By the provider in NPPES
Sex: Male
Sole proprietor: Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2011

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

Specialties & licenses 4

Specialty (taxonomy)	Code	License	State	Primary
Corneal and Contact Management Optometrist	152WC0802X	TUV006648-1	NY	Primary
Corneal and Contact Management Optometrist	152WC0802X	12450	CA
Corneal and Contact Management Optometrist	152WC0802X	OPC 4148	FL
Corneal and Contact Management Optometrist	152WC0802X	1346	AZ

Addresses

Primary practice location

909 Manhattan Ave
Greenpoint Eye Care LLC
Brooklyn, NY 11222-5960

Mailing address

909 Manhattan Ave
Greenpoint Eye Care LLC
Brooklyn, NY 11222-5960
Phone (718) 389-0333

Other identifiers 41

Identifier	Type	State	Issuer
02896642	Other	NY	MEDICAID
2585193	Other		GREAT WEST
57117	Other		NEIGHBOORHOOD
1881673184	Other		MULTIPLAN
57117	Other		HEALTH FIRST
57117	Other		DAVIS VISION
7457515	Other		AETNA
936231	Other		BLOCKVISION
000551510101	Other		HEALTH PLUS
1602400	Other		COVENTRY
1602400	Other		FIRST HEALTH
1881673184	Other		ELDER PLAN
47734	Other		AVESIS
57117	Other		NY PRESBYTERIAN
936231	Other		AMERIGROUP
C399G1	Other		MEDICARE
00002813319-01	Other		UNITED HEALTH CARE
0135527	Other		EMBLEM HEALTH
214775	Other	NY	EYEMED
47175	Other		SPECTERA
C399G2	Other		BLUE CROSS BLUE SHIELD
IE0069	Other		DORAL VISION
IE0069	Other		EYE QUEST VISION
1881673184	Other		BRICKLAYERS
1881673184	Other		ROOFERS WATERPROOFERS
39079	Other		MES VISION
P0T00648	Other		METRO PLUS
1881673184	Other		PHCS
1881673184	Other		VSP
2585193	Other		CIGNA
47175	Other		OPTUM HEALTH
57117	Other		FIDELIS
57117	Other		CSEA
953N	Other		NATIONAL OPTICAL SERVICE
108	Other		VISION SCREENING
1881673184	Other		UNICARE
1881673184	Other		SUPERIOR VISION
330816	Other		NVA
383511P	Other		HIP
6C1614	Other		HEALTH NET
P3814314	Other		OXFORD

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 ID	State	Provider type	PAC ID	Details
I20050726001207	NY	Practitioner - Optometry	3476580960	Practice locations: Brooklyn, NY; Ridgewood, NY

Care Compare profile

Medicare Care Compare

Specialty: Optometry
Education: Other, 2002
Medicare assignment: Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

675 Manhattan Ave
Brooklyn, NY 11222-3113
Phone (718) 389-0333

National Provider Directory

Medicare enrollment (NPD): Enrolled

State licenses

License	State	Type	Specialty
OPC 4148	FL	MD	Corneal and Contact Management Optometrist
TUV006648-1	NY	MD	Corneal and Contact Management Optometrist

Practice roles

Organization	Status	New patients
Sunrx Optical Inc	PastSince Mar 7, 2005	Accepting new patients
Greenpoint Eye Care LLC	Past	Accepting new patients
Clarity Eye Care LLC	Past	Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Greenpoint Eye Care LLC
- Optometrist
- Brooklyn, NY
- NPI 1376941583
NPD (past) Authorized official
Clarity Eye Care LLC
- Optometrist
- Flushing, NY
- NPI 1790201754
NPD (past)
Sunrx Optical Inc
- Eyewear Supplier
- Brooklyn, NY
- NPI 1063517936
NPD (past)

NPI Registry JSON

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309219200000",
    "number": "1881673184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 MANHATTAN AVE",
            "address_2": "GREENPOINT EYE CARE LLC",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112225960",
            "telephone_number": "718-389-0333",
            "fax_number": "718-389-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 MANHATTAN AVE",
            "address_2": "GREENPOINT EYE CARE LLC",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112225960",
            "telephone_number": "718-389-0333",
            "fax_number": "718-389-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISELOW",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2011-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
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            "license": "TUV006648-1",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
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            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
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            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
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            "state": "AZ",
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            "primary": false
        }
    ],
    "identifiers": [
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        {
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            "state": null
        },
        {
            "code": "01",
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            "issuer": "AETNA",
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        {
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            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLUS",
            "identifier": "000551510101",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "1602400",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST  HEALTH",
            "identifier": "1602400",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ELDER PLAN",
            "identifier": "1881673184",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS",
            "identifier": "47734",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY PRESBYTERIAN",
            "identifier": "57117",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "936231",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "C399G1",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "00002813319-01",
            "state": null
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        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMBLEM HEALTH",
            "identifier": "0135527",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "214775",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "47175",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "C399G2",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL VISION",
            "identifier": "IE0069",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYE QUEST VISION",
            "identifier": "IE0069",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRICKLAYERS",
            "identifier": "1881673184",
            "state": null
        },
        {
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            "desc": "Other (non-Medicare)",
            "issuer": "ROOFERS WATERPROOFERS",
            "identifier": "1881673184",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MES VISION",
            "identifier": "39079",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "METRO PLUS",
            "identifier": "P0T00648",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "1881673184",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VSP",
            "identifier": "1881673184",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2585193",
            "state": null
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            "desc": "Other (non-Medicare)",
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            "identifier": "47175",
            "state": null
        },
        {
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            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "57117",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSEA",
            "identifier": "57117",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL OPTICAL SERVICE",
            "identifier": "953N",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VISION SCREENING",
            "identifier": "108",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNICARE",
            "identifier": "1881673184",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUPERIOR VISION",
            "identifier": "1881673184",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NVA",
            "identifier": "330816",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "383511P",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "6C1614",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3814314",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2011; 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.
Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.