Nicole Emily Tilin, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

009867 Issued in NY

Practice address

2136 44TH Dr
Long Island City, NY 11101-4710

Phone

(718) 268-7709

Fax

(929) 562-1545

NPI assigned

Jul 18, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Fresh Eyes Inc

  • Optometrist
  • Fresh Meadows, NY
  • NPI 1043496367
  NPD
• L Eye C Medical Inc

  • Optometrist
  • Long Island City, NY
  • NPI 1225707870
  NPD
• Sound Vision Care, Inc.

  • Eyewear Supplier
  • Riverhead, NY
  • NPI 1487809406

  Optometrist

  NPD
• SVC of Forest Hills One LLC

  • Optometrist
  • Forest Hills, NY
  • NPI 1861003352
  NPD
• SVC of Fresh Meadows LLC

  • Optometrist
  • Fresh Meadows, NY
  • NPI 1891398384
  NPD

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

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1992485635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7235 112TH ST APT 11E",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2136 44TH DR",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111014710",
            "telephone_number": "718-268-7709",
            "fax_number": "929-562-1545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8814 Sutphin Blvd",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "114353711",
            "country_code": "US",
            "telephone_number": "718-739-8939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TILIN",
        "first_name": "NICOLE",
        "middle_name": "EMILY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-18",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "009867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ihasani Thomas, RN
• John Thomas, M.D.
• Jiaxin Tian
• Brigitte Tibana
• Devindra Persaud Tilakdhari, RN
• Andra Tillery
• Damien Tilliman
• Mollie Tishberg
• Reginald Lao Tiu, P.T.
• Taniesha A Todd, RN

• All providers in Long Island City, NY
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.