Organization Active NPI

Ophthalmic Consultant, PLLC

  • Ophthalmology Physician
  • Flushing, NY
National Provider Identifier
1962746693
Registry record updated Jun 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
211188 Issued in NY
Legal business name
OPHTHALMIC CONSULTANT, PLLC
Practice address
134-43 Maple Avenue
Suite 1C
Flushing, NY 11355
Phone
(718) 886-8830
Fax
(718) 886-8825
NPI assigned
Nov 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2015

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

Authorized official

Name
Tung T Chu, MDNPI 1548356454
Title
Director
Phone
(718) 886-8830

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
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 211188 NY Primary

Addresses

Primary practice location

134-43 Maple Avenue
Suite 1C
Flushing, NY 11355

Mailing address

81-30 254TH Street
Floral Park, NY 11004
Phone (718) 886-8830

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141106001567 NY Part B Supplier - Clinic/Group Practice 1052533064 Receives reassigned benefits from 2 practitioners
Practice locations: Flushing, NY

National Provider Directory

National Provider Directory
Tax ID family
Ophthalmic Consultant PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

3808 Union St
Ste 4E
Flushing, NY 11354
Phone (718) 321-8222

13443 Maple Ave
Ste C
Flushing, NY 11355
Phone (718) 886-8830

Practitioners & affiliated clinicians

Practitioners 5

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": "1353283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433376000000",
    "number": "1962746693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81-30 254TH STREET",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "11004",
            "telephone_number": "718-886-8830",
            "fax_number": "718-886-8825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134-43 MAPLE AVENUE",
            "address_2": "SUITE 1C",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11355",
            "telephone_number": "718-886-8830",
            "fax_number": "718-886-8825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPHTHALMIC CONSULTANT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-19",
        "last_updated": "2015-06-04",
        "status": "A",
        "authorized_official_last_name": "CHU",
        "authorized_official_first_name": "TUNG",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "718-886-8830",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "211188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2015; 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.