Individual provider Active NPI

Faisal Aiwzali, OD

  • Optometrist
  • Bay Shore, NY
National Provider Identifier
1972330546
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
011086 Issued in NY
Practice address
1701 Sunrise Hwy
Bay Shore, NY 11706-6091
Phone
(631) 614-2020
NPI assigned
Sep 17, 2024
Last updated
Sep 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 011086 NY Primary

Addresses

Primary practice location

1701 Sunrise Hwy
Bay Shore, NY 11706-6091

Mailing address

33 W 42ND St
New York, NY 10036-8005
Phone (212) 938-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241223002974 NY Practitioner - Optometry 7416484852 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Vision Optometry P.C. Optometrist CurrentSince Nov 1, 2024 Accepting new patients

Locations

1701 Sunrise Hwy
Unit A5
Bay Shore, NY 11706
Phone (631) 614-2020

187 Avenue U
Brooklyn, NY 11223
Phone (718) 373-2020

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1726531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1972330546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 W 42ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100368005",
            "telephone_number": "212-938-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 SUNRISE HWY",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117066091",
            "telephone_number": "631-614-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AIWZALI",
        "first_name": "FAISAL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-17",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "011086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.