MK Optometrist PC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

006662 Issued in NY

Legal business name

MK OPTOMETRIST PC

Doing business as

Advanced Vision Care

Practice address

7221 Austin St
Forest Hills, NY 11375-5354

Phone

(718) 268-4040

Fax

(718) 268-4099

NPI assigned

Oct 17, 2007

Last updated

Jun 7, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael Kakzanov, O.D.NPI 1841378510

Title

President

Phone

(718) 268-4040

Specialties & licenses 1

Addresses

Other names 1

• Advanced Vision Care Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Kakzanov, O.D.

  • Optometrist
  • Forest Hills, NY
  • NPI 1841378510

  Single Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623024000000",
    "number": "1881883601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7221 AUSTIN ST",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755354",
            "telephone_number": "718-268-4040",
            "fax_number": "718-268-4099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7221 AUSTIN ST",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755354",
            "telephone_number": "718-268-4040",
            "fax_number": "718-268-4099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MK OPTOMETRIST PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-17",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A",
        "authorized_official_last_name": "KAKZANOV",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-268-4040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NY",
            "license": "006662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Vision Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Vision Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sheron D Mitchell
• Emanuel Mizrahi, DDS
• Stella Mizrakhi, LCSW
• MJM Medicine PLLC
• MK Ei Services Inc.
• MK Vision Center
• MK Vision Center I, Inc
• MK Vision Center LLC
• MLG Medical , P.C.
• Monika Ewa Mlynarczyk, PT

• Health Service Clinic/Center in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Health Service Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; 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.