Active NPI
Fort Green Vision Corp
- Optician
- Brooklyn, NY
National Provider Identifier
1912320052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 006307
- Legal business name
- FORT GREEN VISION CORP
- Practice address
- 446B Myrtle Ave
Brooklyn, NY 11205-2414 - Phone
- (718) 246-2020
- Fax
- (347) 987-4335
- NPI assigned
- Jan 25, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Boris Rozhansky
- Title
- Manager
- Phone
- (917) 306-5191
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 006307 | NY | Primary |
Addresses
Primary practice location
446B Myrtle Ave
Brooklyn, NY 11205-2414
Mailing address
446B Myrtle Ave
Brooklyn, NY 11205-2414
Phone (718) 246-2020
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D2291772 | Fort Green Vision Inc | Certificate of waiver | Mar 26, 2027 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Low Vision Rehabilitation Optometrist
- Little Neck, NY
- NPI 1104821842
-
- Optometrist
- New York, NY
- NPI 1225466857
-
- Optician
- Staten Island, NY
- NPI 1326288432
-
- Optometrist
- Yonkers, NY
- NPI 1417789686
-
- Optician
- Brooklyn, NY
- NPI 1124196118
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390608000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1696464000000",
"number": "1912320052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "446B MYRTLE AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112052414",
"telephone_number": "718-246-2020",
"fax_number": "347-987-4335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "446B MYRTLE AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112052414",
"telephone_number": "718-246-2020",
"fax_number": "347-987-4335"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FORT GREEN VISION CORP",
"organizational_subpart": "NO",
"enumeration_date": "2014-01-25",
"last_updated": "2023-10-05",
"certification_date": "2023-10-05",
"status": "A",
"authorized_official_last_name": "ROZHANSKY",
"authorized_official_first_name": "BORIS",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "917-306-5191"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Technician/Technologist, Optician",
"state": "NY",
"license": "006307",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.