Vision Vibrant Medicine PLLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

VISION VIBRANT MEDICINE PLLC

Practice address

837 59TH St
Brooklyn, NY 11220-3611

Phone

(718) 680-8881

Fax

(718) 680-7880

NPI assigned

Mar 16, 2020

Last updated

Mar 16, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rebecca Mammo, MD

Title

Owner

Phone

(718) 680-8881

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

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

{
    "created_epoch": "1584316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584316800000",
    "number": "1922634518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "837 59TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203611",
            "telephone_number": "718-680-8881",
            "fax_number": "718-680-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "837 59TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203611",
            "telephone_number": "718-680-8881",
            "fax_number": "718-680-7880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "98 E Broadway Fl 7",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100027181",
            "country_code": "US",
            "telephone_number": "212-226-4848",
            "fax_number": "212-226-4818",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2044 86th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112143216",
            "country_code": "US",
            "telephone_number": "347-462-2278",
            "fax_number": "347-462-2277",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "86 Main St Ste 215",
            "address_purpose": "LOCATION",
            "city": "Yonkers",
            "state": "NY",
            "postal_code": "107018805",
            "country_code": "US",
            "telephone_number": "718-680-8881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VISION VIBRANT MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-16",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A",
        "authorized_official_last_name": "MAMMO",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-680-8881",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.