NPIMap

Organization Active NPI

Eyellusion Vision Center Incorporated

Doing business as Nostlgc Eyewear

  • Optician
  • Plainview, NY
National Provider Identifier
1952852360
Registry record updated Sep 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
006666 Issued in NY
Legal business name
EYELLUSION VISION CENTER INCORPORATED
Doing business as
Nostlgc Eyewear
Practice address
1441 Old Country Rd
Plainview, NY 11803-5010
Phone
(516) 962-9551
Fax
(516) 962-5997
NPI assigned
Oct 20, 2016
Last updated
Sep 24, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
EYELLUSION VISION CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 24, 2022

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

Authorized official

Name
Herminio Fernandez, LICENSED OPTICIANNPI 1477704161
Title
President
Phone
(516) 829-1010

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 006666 NY Primary

Addresses

Primary practice location

1441 Old Country Rd
Plainview, NY 11803-5010

Mailing address

1441 Old Country Rd
Plainview, NY 11803-5010
Phone (516) 962-9551

Other identifiers 1

IdentifierTypeStateIssuer
02291789MedicaidNY

Other names 1

  • Nostlgc Eyewear Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040811000241 NY Part B Supplier - Clinic/Group Practice 8426020777 Receives reassigned benefits from 5 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Woodside, NY; Plainview, NY

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Eyellusion Vision Center Incorporated2 organizations share this tax ID, including this one
Part of
Eyellusion Vision Center Incorporated

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

62 Middle Neck Rd
Great Neck, NY 11021
Phone (516) 829-1010

1441 Old Country Rd
Plainview, NY 11803
Phone (516) 926-9551

6909 Roosevelt Ave
Woodside, NY 11377
Phone (718) 639-1392

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1476921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663977600000",
    "number": "1952852360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 OLD COUNTRY RD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118035010",
            "telephone_number": "516-962-9551",
            "fax_number": "516-962-5997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 OLD COUNTRY RD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118035010",
            "telephone_number": "516-962-9551",
            "fax_number": "516-962-5997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYELLUSION VISION CENTER INCORPORATED",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EYELLUSION VISION CENTER",
        "enumeration_date": "2016-10-20",
        "last_updated": "2022-09-24",
        "certification_date": "2022-09-24",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "HERMINIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-829-1010",
        "authorized_official_credential": "LICENSED OPTICIAN"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "006666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02291789",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nostlgc Eyewear",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nostlgc Eyewear",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plainview, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2022; 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.