Individual provider Active NPI

Steven John Brussich, OPTICIAN

  • Optician
  • Bronx, NY
National Provider Identifier
1912198698
Registry record updated Aug 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
006368-1 Issued in NY
Practice address
5901 Riverdale Ave
Bronx, NY 10471-1602
Phone
(718) 543-3336
Fax
(718) 543-6463
NPI assigned
Aug 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 006368-1 NY Primary

Addresses

Primary practice location

5901 Riverdale Ave
Bronx, NY 10471-1602

Mailing address

5901 Riverdale Ave
Bronx, NY 10471-1602
Phone (718) 543-3336

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
006368-1NYMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Steven John Opticians PLLC 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": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186444800000",
    "number": "1912198698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 RIVERDALE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104711602",
            "telephone_number": "718-543-3336",
            "fax_number": "718-543-6463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 RIVERDALE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104711602",
            "telephone_number": "718-543-3336",
            "fax_number": "718-543-6463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUSSICH",
        "first_name": "STEVEN",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "OPTICIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-07",
        "last_updated": "2007-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "006368-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2007; 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.