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MOUNT TABOR MEDICAL PC
NPI 1356123947
Optometrist in Brooklyn, NY

Active since October 18, 2023
1435 64TH ST # 2A, BROOKLYN, NY 11219(212) 739-1799 Get Directions Write a Review

NPPES record last updated: October 26, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 26, 2023, Oct 18, 2023 (2 updates tracked since 2023).

About Mount Tabor Medical Pc NPPES

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

MOUNT TABOR MEDICAL PC (NPI 1356123947) is a healthcare organization registered as an optometrist in Brooklyn, New York and active in the NPI registry since October 2023. The organization lists Eli Inzlicht-sprei, Owner, as its authorized official.

NPPES Registry Identity

NPI1356123947
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameMOUNT TABOR MEDICAL PC
Location Address1435 64TH ST # 2ABrooklyn, NY 11219-5733
Mailing Address5314 16th Ave Ste 197Brooklyn, NY 11204-1425 · (212) 739-1799
Phone(212) 739-1799
Organization SubpartNo
Authorized OfficialEli Inzlicht-spreiOwner · (917) 415-5147
Enumeration DateOctober 18, 2023
Last NPPES UpdateOctober 26, 20232 updates tracked since enumeration
NPPES CertifiedOctober 26, 2023
✔ NPI 1356123947 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
1435 64TH ST # 2A, Brooklyn, NY 11219
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.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)

Mount Tabor Medical Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

8

Medicare enrollment records show 8 clinicians reassign Medicare billing to Mount Tabor Medical PC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (8)

Kimberly Murray, OD
Optometry
NPI 1699361915
398 BRIDGE ST
Brooklyn, NY 11201
(718) 865-8159
✔ PECOS4.6 mi
Shira Nissel, O.D
Optometry
NPI 1275897936
30 E 40TH ST 203
New York, NY 10016
(212) 889-3550
✔ PECOS8.8 mi
Aurora Axin Tussy, O.D., F.A.A.O.
Optometry
NPI 1245375716
679 W 239TH ST #1A
Bronx, NY 10463
(718) 601-4930
✔ PECOS✔ Accepts Medicare19 mi
Alice Hart, O.D.
Optometry
NPI 1760812143
400 S SERVICE RD
Melville, NY 11747
(631) 439-3000
✔ PECOS✔ Accepts Medicare33 mi
David Giusti, OD
Optometry
NPI 1376173757
612 CORPORATE WAY STE 3
Valley Cottage, NY 10989
(845) 268-0045
✔ PECOS35 mi
Katarina Kozer, OD
Optometry
NPI 1063304178
2094 ALBANY POST RD
Montrose, NY 10548
(914) 737-4400
✔ PECOS✔ Accepts Medicare43 mi
Lily Li, OD
Optometry
NPI 1649611831
2343B S WENTWORTH AVE
Chicago, IL 60616
(312) 225-5829
✔ PECOS✔ Accepts Medicare714 mi
Teresa Lim, O.D.
Optometry
NPI 1558553081
11301 WILSHIRE BLVD BLDG 304 RM 2-111
Los Angeles, CA 90073
(310) 478-3711
✔ PECOS✔ Accepts Medicare2,463 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 Mount Tabor Medical PC's NPI number?

The NPI number for Mount Tabor Medical PC is 1356123947. It was assigned to this organization in the NPPES registry on October 18, 2023.

Where is Mount Tabor Medical PC located?

Mount Tabor Medical PC is located at 1435 64th St # 2A, Brooklyn, NY 11219. The listed phone number is (212) 739-1799.

What is Mount Tabor Medical PC's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Mount Tabor Medical PC enrolled in Medicare?

Yes. Mount Tabor Medical PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mount Tabor Medical PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians, all in Optometry, reassign their Medicare billing to Mount Tabor Medical PC. 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. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Mount Tabor Medical PC accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Mount Tabor Medical PC 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 Mount Tabor Medical PC was last updated on October 26, 2023. 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.