Active NPI
Sung Yoo, O.D.
- Optometrist
- Selden, NY
National Provider Identifier
1972748184
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TUV007314-1
- Practice address
- 349 Independence PLZ
Selden, NY 11784-2400 - Phone
- (631) 736-8969
- NPI assigned
- Dec 3, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | TUV007314-1 | NY | Primary |
Addresses
Primary practice location
349 Independence PLZ
Selden, NY 11784-2400
Mailing address
81 Village Green Dr
Port Jefferson Station, NY 11776-4510
Phone (631) 255-6429
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TUV007314-1 | NY | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Custom Eyes Inc. | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Point of Service
- Selden, NY
- NPI 1992984504
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228262400000",
"number": "1972748184",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "81 VILLAGE GREEN DR",
"city": "PORT JEFFERSON STATION",
"state": "NY",
"postal_code": "117764510",
"telephone_number": "631-255-6429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "349 INDEPENDENCE PLZ",
"city": "SELDEN",
"state": "NY",
"postal_code": "117842400",
"telephone_number": "631-736-8969"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOO",
"first_name": "SUNG",
"name_prefix": "Mr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-12-03",
"last_updated": "2008-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "TUV007314-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Selden, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.