Individual provider Active NPI

Jaswant Kaur, OD

  • Optometrist
  • Hicksville, NY
National Provider Identifier
1922695550
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
009298 Issued in NY
Practice address
881 Broadway Mall
Hicksville, NY 11801-2712
Phone
(516) 938-6006
Fax
(516) 513-0156
NPI assigned
Dec 29, 2020
Last updated
Dec 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 009298 NY Primary

Addresses

Primary practice location

881 Broadway Mall
Hicksville, NY 11801-2712

Mailing address

90 Percheron LN
Roslyn Heights, NY 11577-2817
Phone (516) 701-7037

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210706000615 NY Practitioner - Optometry 4486056090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

358 B Broadway Mall
Suite 881
Hicksville, NY 11801-2709
Phone (516) 938-6006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Annette Optical Inc CurrentSince Jan 3, 2021 Accepting new patients
Hicksville Optometry PC Optometrist CurrentSince Jun 1, 2021 Accepting new patients
Broadway Mall Eye Care LLC PastSince Sep 13, 2020 Accepting new patients
Teragram I, Inc. Optometrist PastSince Jan 3, 2021 Accepting new patients

Locations

187 Avenue U
Brooklyn, NY 11223
Phone (718) 373-2020

358 Broadway Mall
Ste 881
Hicksville, NY 11801

358B Broadway Mall
Ste 881
Hicksville, NY 11801
Phone (516) 938-6006

881 Broadway Mall
Hicksville, NY 11801
Phone (516) 938-2712

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1609200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1922695550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 PERCHERON LN",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115772817",
            "telephone_number": "516-701-7037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "881 BROADWAY MALL",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118012712",
            "telephone_number": "516-938-6006",
            "fax_number": "516-513-0156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUR",
        "first_name": "JASWANT",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-29",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "009298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hicksville, NY

Sources for this page

Verify at the official NPI Registry.