Individual provider Active NPI

Iosif Ifraimov

  • Optician
  • Cedarhurst, NY
National Provider Identifier
1902304207
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
009518 Issued in NY
Practice address
482 Central Ave
Cedarhurst, NY 11516-2007
Phone
(516) 792-5656
NPI assigned
Feb 1, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 009518 NY Primary

Addresses

Primary practice location

482 Central Ave
Cedarhurst, NY 11516-2007

Mailing address

482 Central Ave
Cedarhurst, NY 11516-2007
Phone (516) 792-5656

Other identifiers 1

IdentifierTypeStateIssuer
82-3299832OtherNYRESALE CERTIFICATE

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
009518NYMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Optiks Inc. Optician 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": "1517443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1902304207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "482 CENTRAL AVE",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115162007",
            "telephone_number": "516-792-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "482 CENTRAL AVE",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115162007",
            "telephone_number": "516-792-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IFRAIMOV",
        "first_name": "IOSIF",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-01",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "009518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RESALE CERTIFICATE",
            "identifier": "82-3299832",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedarhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.