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BROOKLYN OPHTHALMOLOGY PLLC
NPI 1104205780
Ophthalmology in Brooklyn, NY

Active since May 28, 2015CLIA 33D2132289 · Waiver
4014 CHURCH AVE, BROOKLYN, NY 11203(718) 287-2020(516) 829-2026 Get Directions Write a Review

NPPES record last updated: January 25, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 13, 2021, Nov 18, 2021, Jan 23, 2017 (3 updates tracked since 2017).

About Brooklyn Ophthalmology Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BROOKLYN OPHTHALMOLOGY PLLC (NPI 1104205780) is a healthcare organization registered as an ophthalmology in Brooklyn, New York and active in the NPI registry since May 2015. The organization holds a CLIA Waiver certificate valid through June 14, 2027 and lists Daniel K Khodadadian, Ceo President, as its authorized official.

NPPES Registry Identity

NPI1104205780
Entity TypeOrganization
Primary Taxonomy207W00000X
Legal Business NameBROOKLYN OPHTHALMOLOGY PLLC
Location Address4014 CHURCH AVEBrooklyn, NY 11203-2917
Mailing Address18 Franklin PlGreat Neck, NY 11023-1229 · (718) 287-2020 · Fax (718) 287-2026
Phone(718) 287-2020
Fax(516) 829-2026
Organization SubpartNo
Authorized OfficialDaniel K KhodadadianCeo President · (718) 287-2020
Enumeration DateMay 28, 2015
Last NPPES UpdateJanuary 25, 20243 updates tracked since enumeration
NPPES CertifiedJanuary 25, 2024
✔ NPI 1104205780 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in NY · 206436
Definition
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.
4014 CHURCH AVE, Brooklyn, NY 11203
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2132289

Brooklyn Ophthalmology PLLC · Brooklyn, NY
Active · expires Jun 14, 2027
CLIA Number33D2132289
Laboratory TypePhysician Office
Certificate Effective DateJune 15, 2025
Certificate Expiration DateJune 14, 2027
Laboratory DirectorDr. Daniel Khodadadian
Laboratory Phone(347) 537-3544
Laboratory LocationBrooklyn Ophthalmology PLLC4014 Church Avenue, Brooklyn, NY 11203
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brooklyn Ophthalmology PLLC's NPI number?

The NPI number for Brooklyn Ophthalmology PLLC is 1104205780. It was assigned to this organization in the NPPES registry on May 28, 2015.

Where is Brooklyn Ophthalmology PLLC located?

Brooklyn Ophthalmology PLLC is located at 4014 Church Ave, Brooklyn, NY 11203. The listed phone number is (718) 287-2020.

What is Brooklyn Ophthalmology PLLC's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Does Brooklyn Ophthalmology PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2132289) is associated with this NPI, valid through June 14, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Brooklyn Ophthalmology PLLC was last updated on January 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.