Individual provider Active NPI

Katerina Ginberg, OD

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1972695807
Registry record updated Mar 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV006809 Issued in NY
Practice address
12073 Flatlands Ave
Brooklyn, NY 11207-8306
Phone
(718) 257-7700
Fax
(718) 257-7704
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV006809 NY Primary

Addresses

Primary practice location

12073 Flatlands Ave
Brooklyn, NY 11207-8306

Mailing address

419 Fawns Run
Morganville, NJ 07751-4403
Phone (917) 945-5636

Other identifiers 1

IdentifierTypeStateIssuer
02642024MedicaidNY

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
I20050329000287 NY Practitioner - Optometry 4981650314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12073 Flatlands Ave
Brooklyn, NY 11207-8306
Phone (718) 257-7700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV006809NYMDOptometrist
006809NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Ace Optical Incorporated Past Accepting new patients
State of New York Comptrollers Office Past Accepting new patients
State of New York Comptrollers Office Optometrist Past Accepting new patients

Organizations & group practices 4

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427241600000",
    "number": "1972695807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 FAWNS RUN",
            "city": "MORGANVILLE",
            "state": "NJ",
            "postal_code": "077514403",
            "telephone_number": "917-945-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12073 FLATLANDS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112078306",
            "telephone_number": "718-257-7700",
            "fax_number": "718-257-7704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GINBERG",
        "first_name": "KATERINA",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2015-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02642024",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.