Organization Active NPI

Harlem Vistasite Eye Care Inc

  • Optometrist
  • New York, NY
National Provider Identifier
1942768387
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
HARLEM VISTASITE EYE CARE INC
Practice address
2204 Frederick Douglass Blvd
New York, NY 10026-1172
Phone
(646) 895-9000
Fax
(646) 891-0202
NPI assigned
Mar 5, 2019
Last updated
Jan 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Authorized official

Name
Mr. Sidney Contreras
Title
Administrator
Phone
(917) 969-4361

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary

Addresses

Primary practice location

2204 Frederick Douglass Blvd
New York, NY 10026-1172

Mailing address

2204 Frederick Douglass Blvd
New York, NY 10026-1172
Phone (917) 969-4361

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190416002264 NY Part B Supplier - Clinic/Group Practice 2860733011 Receives reassigned benefits from 6 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

2204 Frederick Douglass Blvd
New York, NY 10026
Phone (646) 895-9000

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1551744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674518400000",
    "number": "1942768387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 FREDERICK DOUGLASS BLVD",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100261172",
            "telephone_number": "917-969-4361",
            "fax_number": "212-938-5831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 FREDERICK DOUGLASS BLVD",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100261172",
            "telephone_number": "646-895-9000",
            "fax_number": "646-891-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARLEM VISTASITE EYE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-05",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A",
        "authorized_official_last_name": "CONTRERAS",
        "authorized_official_first_name": "SIDNEY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "917-969-4361",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; 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.