Individual provider Active NPI

Vithushan Nimalan

  • Optometrist
  • Lindenhurst, NY
National Provider Identifier
1932081064
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
011211 Issued in NY
Practice address
600 Wellwood Ave
Lindenhurst, NY 11757-2000
Phone
(631) 957-0033
NPI assigned
Jul 21, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 011211 NY Primary

Addresses

Primary practice location

600 Wellwood Ave
Lindenhurst, NY 11757-2000

Mailing address

600 Wellwood Ave
Lindenhurst, NY 11757-2000
Phone (516) 884-3679

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
I20251001002895 NY Practitioner - Optometry 0840796512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

221 Park Ave
Garden City Park, NY 11040-5320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011211NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Values Inc Optometrist CurrentSince Sep 24, 2025 Accepting new patients

Locations

600 Wellwood Ave
Ste C
Lindenhurst, NY 11757
Phone (631) 957-0033

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": "1753056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1932081064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 WELLWOOD AVE",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117572000",
            "telephone_number": "516-884-3679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 WELLWOOD AVE",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117572000",
            "telephone_number": "631-957-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIMALAN",
        "first_name": "VITHUSHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-21",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "011211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lindenhurst, NY

Sources for this page

Verify at the official NPI Registry.