Individual provider Active NPI

Faina Khmelnitsky, OD

  • Optometrist
  • New York, NY
National Provider Identifier
1891983920
Registry record updated Jun 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV006850 Issued in NY
Practice address
425 Madison Ave
New York, NY 10017-3422
Phone
(212) 230-1780
Fax
(212) 683-1947
NPI assigned
Oct 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV006850 NY Primary

Addresses

Primary practice location

425 Madison Ave
New York, NY 10017-3422

Mailing address

425 Madison Ave
Suite 1501
New York, NY 10017-1110
Phone (212) 230-1780

Other identifiers 1

IdentifierTypeStateIssuer
02655085MedicaidNY

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV006850NYMDOptometrist
006850NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Vision, Inc Optometrist Past Accepting new patients

Organizations & group practices 1

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": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465171200000",
    "number": "1891983920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 MADISON AVE",
            "address_2": "SUITE 1501",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100171110",
            "telephone_number": "212-230-1780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100173422",
            "telephone_number": "212-230-1780",
            "fax_number": "212-683-1947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHMELNITSKY",
        "first_name": "FAINA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-15",
        "last_updated": "2016-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02655085",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.