Individual provider Active NPI

Brian Helmetag, OD

  • Optometrist
  • Philadelphia, PA
National Provider Identifier
1891439261
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG003921 Issued in PA
Practice address
1200 W Godfrey Ave
Philadelphia, PA 19141-3323
Phone
(215) 276-6000
NPI assigned
Apr 22, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG003921 PA Primary

Addresses

Primary practice location

1200 W Godfrey Ave
Philadelphia, PA 19141-3323

Mailing address

106 Carter LN
Camden, DE 19934-1213
Phone (302) 724-0341

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
I20231107000791 NY Practitioner - Optometry 0244615680 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wyckoff Professional Medical Services PCGroup PAC ID 6406748607, 154 clinicians

Practice addresses (Care Compare)

374 Stockholm St
Brooklyn, NY 11237-4006
Phone (718) 963-7266

Hospital & facility affiliations

  • Wyckoff Heights Medical Center Hospital, Brooklyn, NY, CCN 330221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009871NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Harooni & Sheindlin MD PC CurrentSince Nov 5, 2023 Accepting new patients
Pennsylvania College of Optometry Optometrist Current Accepting new patients
Wyckoff Professional Medical Services, PC CurrentSince Sep 16, 2023 Accepting new patients
Medalliance Medical Health Services Inc Past Accepting new patients

Locations

109 4th Ave
Brooklyn, NY 11217
Phone (718) 438-5600

586 President St
Ste B
Brooklyn, NY 11215
Phone (718) 438-5600

1530 Bedford Ave
Brooklyn, NY 11216
Phone (718) 221-2020

374 Stockholm St
Brooklyn, NY 11237
Phone (718) 963-6485

5205 Church Ave
Brooklyn, NY 11203
Phone (718) 342-2500

1200 W Godfrey Ave
Philadelphia, PA 19141
Phone (215) 276-6000

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1650585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1891439261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 CARTER LN",
            "city": "CAMDEN",
            "state": "DE",
            "postal_code": "199341213",
            "telephone_number": "302-724-0341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W GODFREY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413323",
            "telephone_number": "215-276-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELMETAG",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-22",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.