Individual provider Active NPI

Eliza Yaghoubian, O.D.

  • Optometrist
  • New York, NY
National Provider Identifier
1972689255
Registry record updated Nov 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
007105 Issued in NY
Practice address
33 W 42ND St
New York, NY 10036-8005
Phone
(212) 938-4400
NPI assigned
Oct 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 007105 NY Primary

Addresses

Primary practice location

33 W 42ND St
New York, NY 10036-8005

Mailing address

60 Willow Park Ctr
Apt #3F
Farmingdale, NY 11735-1001
Phone (646) 431-4400

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
I20080317000488 NY Practitioner - Optometry 5991880841 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Glasses Guy 18Inc Optometrist CurrentSince Jul 1, 2025 Accepting new patients
Differ Partners, LLC CurrentSince Nov 1, 2016 Accepting new patients
Eyellusion Vision Center Incorporated CurrentSince May 11, 2018 Accepting new patients
Eyellusion Vision Center Incorporated CurrentSince May 11, 2018 Accepting new patients
Eyeglass Depot Optical PastSince Nov 1, 2016 Accepting new patients
Mobile Medical Eye Care, P.C. Past Accepting new patients

Locations

60 Willow Park Ctr
Apt 3F
Farmingdale, NY 11735

60 Willow Park Ctr
Farmingdale, NY 11735
Phone (631) 777-7283

78 Rockaway Ave
Valley Stream, NY 11580
Phone (516) 341-0485

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

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478736000000",
    "number": "1972689255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 WILLOW PARK CTR",
            "address_2": "APT #3F",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117351001",
            "telephone_number": "646-431-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 W 42ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100368005",
            "telephone_number": "212-938-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAGHOUBIAN",
        "first_name": "ELIZA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-28",
        "last_updated": "2016-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "007105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.