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FABULOUS OPTICAL
NPI 1265106496
Optometrist - Vision Therapy in Bronx, NY

Active since August 02, 2021
691H COOP CITY BLVD, BRONX, NY 10475(917) 642-1035 Get Directions Write a Review

NPPES record last updated: January 19, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jan 19, 2022, Nov 19, 2021, Aug 2, 2021 (3 updates tracked since 2021).

About Fabulous Optical NPPES

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

FABULOUS OPTICAL (NPI 1265106496) is a healthcare organization registered as a vision therapy in Bronx, New York and active in the NPI registry since August 2021. The organization lists Edward Bangiyev, Owner/president, as its authorized official.

NPPES Registry Identity

NPI1265106496
Entity TypeOrganization
Primary Taxonomy152WV0400X
Legal Business NameSUPREME VISION CENTER INC
Location Address691H COOP CITY BLVDBronx, NY 10475-1673
Mailing Address200 W 125th StNew York, NY 10027-4410 · (212) 665-5051 · Fax (212) 203-0399
Phone(917) 642-1035
Organization SubpartNo
Authorized OfficialEdward BangiyevOwner/president · (718) 866-1740
Enumeration DateAugust 2, 2021
Last NPPES UpdateJanuary 19, 20223 updates tracked since enumeration
NPPES CertifiedJanuary 19, 2022
✔ NPI 1265106496 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometrist · Vision TherapyEye and Vision Services Providers
Taxonomy Code152WV0400X
Definition
Optometrists who specialize in vision therapy as a treatment process used to improve vision function. It includes a broad range of developmental and rehabilitative treatment programs individually prescribed to remediate specific sensory, motor and/or visual perceptual dysfunctions.
691H COOP CITY BLVD, Bronx, NY 10475
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Other Names 1

Doing Business AsFabulous Optical

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BlueCross BlueShield of Tennessee.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Fabulous Optical is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Fabulous Optical, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (2)

Tammy Ngo, O.D.
Optometry
NPI 1275581209
33 W 42ND ST
New York, NY 10036
(212) 938-4173
✔ PECOS✔ Accepts Medicare12 mi
Lindsey Chan, OD
Optometry
NPI 1295563146
546 NOSTRAND AVE
Brooklyn, NY 11216
(718) 230-0774
✔ PECOS15 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Supreme Vision Center Inc's NPI number?

The NPI number for Supreme Vision Center Inc is 1265106496. It was assigned to this organization in the NPPES registry on August 2, 2021. The provider is doing business as Fabulous Optical.

Where is Supreme Vision Center Inc located?

Supreme Vision Center Inc is located at 691H Coop City Blvd, Bronx, NY 10475. The listed phone number is (917) 642-1035.

What is Supreme Vision Center Inc's specialty?

The primary specialty registered for this NPI is Optometrist, specializing in Vision Therapy, with taxonomy code 152WV0400X.

Is Supreme Vision Center Inc enrolled in Medicare?

Yes. Supreme Vision Center Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Supreme Vision Center Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Optometry, reassign their Medicare billing to Supreme Vision Center Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Supreme Vision Center Inc accept?

Health plans from Anthem Blue Cross and Blue Shield and BlueCross BlueShield of Tennessee list Supreme Vision Center Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Supreme Vision Center Inc was last updated on January 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.