Individual provider Active NPI

Yajaira Rosemary Fernandez, OD

  • Optometrist
  • Bronx, NY
National Provider Identifier
1881764645
Registry record updated Oct 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV006823 Issued in NY
Practice address
250 Baychester Ave
Bronx, NY 10475-4575
Phone
(929) 297-0483
NPI assigned
Nov 9, 2006
Last updated
Oct 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 006823 NY
Optometrist 152W00000X TUV006823 NY Primary

Addresses

Primary practice location

250 Baychester Ave
Bronx, NY 10475-4575

Mailing address

3142 Waterbury Ave
Bronx, NY 10465-1438
Phone (646) 373-4401

Other identifiers 3

IdentifierTypeStateIssuer
006823OtherNYLICENSE
11728195OtherCAQH
02611329MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV006823NYMDOptometrist
006823NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Castle Hill Optometry PLLC Optometrist CurrentSince Jun 2, 2019 Accepting new patients
Luxottica of America Inc. CurrentSince Oct 24, 2021 Accepting new patients
Buena Vista Vision Center, Inc Optometrist PastSince Mar 30, 2004 Accepting new patients
Leslie E. Gordon, MD P.C. PastSince Dec 1, 2020 Accepting new patients
Luxottica of America Inc PastSince Oct 24, 2021 Accepting new patients
Allerton Eye Care LLC Optometrist PastSince Jun 6, 2023 Accepting new patients

Locations

1264 Castle Hill Ave
Bronx, NY 10462
Phone (718) 823-5006

250 Baychester Ave
Bronx, NY 10475
Phone (929) 297-0483

4000 Luxottica Pl
Mason, OH 45040
Phone (513) 765-2155

Organizations & group practices 6

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": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634860800000",
    "number": "1881764645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3142 WATERBURY AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104651438",
            "telephone_number": "646-373-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 BAYCHESTER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104754575",
            "telephone_number": "929-297-0483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "YAJAIRA",
        "middle_name": "ROSEMARY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2021-10-22",
        "certification_date": "2021-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "006823",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "006823",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11728195",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02611329",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.