Active NPI
Rosalyn Angela Lilienthal, OD
- Optometrist
- Holbrook, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPC6105
- Practice address
- 20 Peachtree CT Ste H&103a
Holbrook, NY 11741-4616 - Phone
- (844) 843-2020
- NPI assigned
- May 7, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1089 | NH | |
| Optometrist | 152W00000X | 3822 | TN | |
| Optometrist | 152W00000X | OPT-002626 | AZ | |
| Optometrist | 152W00000X | OEG003960 | PA | |
| Optometrist | 152W00000X | 046011707 | IL | |
| Optometrist | 152W00000X | S-F12-TA-C78 | AL | |
| Optometrist | 152W00000X | 115200 | IA | |
| Optometrist | 152W00000X | 10727 | TX | |
| Optometrist | 152W00000X | ODTG00747 | RI | |
| Optometrist | 152W00000X | TA2876 | MD | |
| Optometrist | 152W00000X | OPC6105 | FL | Primary |
| Optometrist | 152W00000X | 003310 | CT | |
| Optometrist | 152W00000X | 009688 | NY | |
| Optometrist | 152W00000X | OPT.0004028 | CO | |
| Optometrist | 152W00000X | 0618003156 | VA |
Addresses
Primary practice location
20 Peachtree CT Ste H&103a
Holbrook, NY 11741-4616
Mailing address
17249 Lawrence Way
Grass Valley, CA 95949-7175
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- New England College of Optometry, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1 Vermont Dr
New Hyde Park, NY 11042-1128
2121 Ala Wai Blvd
Apt 3306
Honolulu, HI 96815-2209
5 Dakota Dr
Suite 307
New Hyde Park, NY 11042-1106
5 Dakota Dr
Suite 307
New Hyde Park, NY 11042-1188
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TBD | FL | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 20/20 Vision Services PC | Optometrist | Current | Accepting new patients |
Locations
20 Peachtree Ct
Ste 103H
Holbrook, NY 11741
Phone (201) 572-4039
1887 Elmira St
Sayre, PA 18840
Phone (570) 888-3729
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": "1651881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784073600000",
"number": "1932845435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17249 LAWRENCE WAY",
"city": "GRASS VALLEY",
"state": "CA",
"postal_code": "959497175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 PEACHTREE CT STE H&103A",
"city": "HOLBROOK",
"state": "NY",
"postal_code": "117414616",
"telephone_number": "844-843-2020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LILIENTHAL",
"first_name": "ROSALYN",
"middle_name": "ANGELA",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-07",
"last_updated": "2026-07-15",
"certification_date": "2026-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NH",
"license": "1089",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TN",
"license": "3822",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AZ",
"license": "OPT-002626",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PA",
"license": "OEG003960",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046011707",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AL",
"license": "S-F12-TA-C78",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IA",
"license": "115200",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "10727",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "RI",
"license": "ODTG00747",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MD",
"license": "TA2876",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "OPC6105",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CT",
"license": "003310",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "009688",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CO",
"license": "OPT.0004028",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "VA",
"license": "0618003156",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Holbrook, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.