1. Home
  2. Directory
  3. New York
  4. Deer Park
  5. Eyewear Supplier
  6. NPI Profile

OPTICAL SHOP OF DEER PARK INC
NPI 1386101632
Eyewear Supplier in Deer Park, NY

Active since February 22, 2019
415 COMMACK RD STE 2B, DEER PARK, NY 11729(631) 392-0711(631) 392-0752 Get Directions Write a Review

NPPES record last updated: July 2, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 2, 2019, Feb 22, 2019 (2 updates tracked since 2019).

About Optical Shop Of Deer Park Inc NPPES

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

OPTICAL SHOP OF DEER PARK INC (NPI 1386101632) is a healthcare organization registered as an eyewear supplier in Deer Park, New York and active in the NPI registry since February 2019. The organization lists Leonid Gladstein, Owner, as its authorized official.

NPPES Registry Identity

NPI1386101632
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameOPTICAL SHOP OF DEER PARK INC
Location Address415 COMMACK RD STE 2BDeer Park, NY 11729-4508
Mailing Address415 Commack Rd Ste 2bDeer Park, NY 11729-4508 · (631) 392-0711 · Fax (631) 392-0752
Phone(631) 392-0711
Fax(631) 392-0752
Organization SubpartNo
Authorized OfficialLeonid GladsteinOwner · (917) 887-8872
Enumeration DateFebruary 22, 2019
Last NPPES UpdateJuly 2, 20192 updates tracked since enumeration
✔ NPI 1386101632 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEyewear SupplierSuppliers
Taxonomy Code332H00000X
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
Also ListedOptometristTaxonomy 152W00000X
415 COMMACK RD STE 2B, Deer Park, NY 11729
Open in Google Maps ↗

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, Blue Cross and Blue Shield of Louisiana, Blue Cross Blue Shield of Wyoming.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)

Optical Shop Of Deer Park Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Optical Shop Of Deer Park Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Edward Deneve, O.D.
Optometry
NPI 1114074945
5 BELLPORT LN
Bellport, NY 11713
(631) 286-4014
✔ PECOS✔ Accepts Medicare20 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 Optical Shop Of Deer Park Inc's NPI number?

The NPI number for Optical Shop Of Deer Park Inc is 1386101632. It was assigned to this organization in the NPPES registry on February 22, 2019.

Where is Optical Shop Of Deer Park Inc located?

Optical Shop Of Deer Park Inc is located at 415 Commack Rd Ste 2B, Deer Park, NY 11729. The listed phone number is (631) 392-0711.

What is Optical Shop Of Deer Park Inc's specialty?

The primary specialty registered for this NPI is Eyewear Supplier with taxonomy code 332H00000X.

Is Optical Shop Of Deer Park Inc enrolled in Medicare?

Yes. Optical Shop Of Deer Park Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Optical Shop Of Deer Park Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Optometry) reassigns their Medicare billing to Optical Shop Of Deer Park 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 Optical Shop Of Deer Park Inc accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Wyoming and Blue Cross and Blue Shield of Louisiana list Optical Shop Of Deer Park 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 Optical Shop Of Deer Park Inc was last updated on July 2, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.