Individual provider Active NPI

Mary Claire Carandang, OD

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1891234654
Registry record updated Feb 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T008544 Issued in NY
Practice address
453 Court St
Brooklyn, NY 11231-4595
Phone
(718) 625-7300
NPI assigned
Feb 13, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T008544 NY Primary

Addresses

Primary practice location

453 Court St
Brooklyn, NY 11231-4595

Mailing address

453 Court St
Brooklyn, NY 11231-4595
Phone (718) 625-7300

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
I20171011001812 NY Practitioner - Optometry 4981979366 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T008544NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
MCC Optometry of Roosevelt PLLC Optometrist CurrentSince Aug 14, 2017 Accepting new patients
Couture Optical of Carroll Gardens LLC Optometrist PastSince Nov 17, 2019 Accepting new patients

Locations

3938 62nd St
Woodside, NY 11377
Phone (718) 427-4795

Organizations & group practices 2

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": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487116800000",
    "number": "1891234654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "453 COURT ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112314595",
            "telephone_number": "718-625-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "453 COURT ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112314595",
            "telephone_number": "718-625-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARANDANG",
        "first_name": "MARY CLAIRE",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-13",
        "last_updated": "2017-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "T008544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.