Organization Active NPI

Odyssey Optics LTD

Doing business as odyssey optical inc

  • Optometrist
  • Astoria, NY
National Provider Identifier
1962594200
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
VUT005798-1 Issued in NY
Legal business name
ODYSSEY OPTICS LTD
Doing business as
odyssey optical inc
Practice address
2238 31St St
Astoria, NY 11105-2714
Phone
(718) 278-3600
Fax
(718) 278-3865
NPI assigned
Sep 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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

Authorized official

Name
Dr. Hope Patricia Muller-McGovern, O.DNPI 1245291814
Title
President
Phone
(718) 278-3600

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X VUT005798-1 NY Primary

Addresses

Primary practice location

2238 31St St
Astoria, NY 11105-2714

Mailing address

2238 31St St
Astoria, NY 11105-2714
Phone (718) 278-3600

Other names 1

  • odyssey optical inc Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070212000449 NY Part B Supplier - Clinic/Group Practice 8628070240 Receives reassigned benefits from 2 practitioners
Practice locations: Astoria, NY

National Provider Directory

National Provider Directory

Locations

2238 31st St
Astoria, NY 11105
Phone (718) 278-3600

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1962594200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2238 31ST ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111052714",
            "telephone_number": "718-278-3600",
            "fax_number": "718-278-3865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2238 31ST ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111052714",
            "telephone_number": "718-278-3600",
            "fax_number": "718-278-3865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODYSSEY OPTICS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "MULLER-MCGOVERN",
        "authorized_official_first_name": "HOPE",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-278-3600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "VUT005798-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "odyssey optical inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.