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DR. BOAZ J LISSAUER MD NPI 1639173123


NPI Information

NPI: 1639173123
Provider Name: DR. BOAZ J LISSAUER, MD
Classification: Ophthalmology - 207W00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
1036 PARK AVE
SUITE 1C
NEW YORK, NY
ZIP 10028
Phone: (212) 717-2150
Get Directions

DR. Boaz J Lissauer, MD is an ophthalmology in New York, NY. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. DR. Boaz J Lissauer, MD NPI is 1639173123. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1036 PARK AVE
SUITE 1C
NEW YORK, NY
ZIP 10028-971
Phone: (212) 717-2150
Fax: (212) 717-2154

The NPI 1639173123 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/13/2005 and was last updated on 6/25/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207W00000XOphthalmology25MA07699200NEW JERSEYNo
22086S0122XSurgeryPlastic and Reconstructive Surgery25MA07699200NEW JERSEYNo
32086S0122XSurgeryPlastic and Reconstructive Surgery208452NEW YORKNo
4207W00000XOphthalmology208452NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1271252BOTHERNEW YORKDIVISION 1181 MAGNACARE
2P2647045OTHEROXFORD
3208452OTHERNEW YORKHIP
47554155OTHERAETNA
5H38324MEDICARE UPIN
61000035875OTHERNEW YORKAFFNITY HEALTH PLAN
70498250OTHERNEW YORKGHI
8377A91MEDICARE ID-TYPE UNSPECIFIEDNEW YORK
9BL0482B310OTHERNEW YORKBLUE CROSS BLUE SHIELD
10BL0482B310OTHERNEW YORKFEDERAL BLUE CROSS BLUE S

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.