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VISTASITE
NPI 1578052791
Clinic/Center - Ophthalmologic Surgery in New York, NY

Active since May 02, 2018
4204 BROADWAY, NEW YORK, NY 10033(917) 261-6100(917) 861-6697 Get Directions Write a Review

NPPES record last updated: March 15, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 15, 2021, May 2, 2018 (2 updates tracked since 2018).

About Vistasite NPPES

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

VISTASITE (NPI 1578052791) is a healthcare organization registered as an ophthalmologic surgery in New York, New York and active in the NPI registry since May 2018. The organization lists Vladimir Dvoretsky, Od, as its authorized official.

NPPES Registry Identity

NPI1578052791
Entity TypeOrganization
Primary Taxonomy261QS0132X
Legal Business NameVISTASITE OPTIQUE INC
Location Address4204 BROADWAYNew York, NY 10033-3706
Mailing Address4204 BroadwayNew York, NY 10033-3706 · (917) 261-6100 · Fax (917) 861-6697
Phone(917) 261-6100
Fax(917) 861-6697
Organization SubpartNo
Authorized OfficialVladimir DvoretskyOd · (212) 433-0136
Enumeration DateMay 2, 2018
Last NPPES UpdateMarch 15, 20212 updates tracked since enumeration
NPPES CertifiedMarch 15, 2021
✔ NPI 1578052791 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ophthalmologic SurgeryAmbulatory Health Care Facilities
Taxonomy Code261QS0132X
4204 BROADWAY, New York, NY 10033
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Other Names 1

Doing Business AsVistasite

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 Montana, Blue Cross and Blue Shield of Oklahoma and more.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)

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

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Vistasite, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Martin Mundackal, OD
Optometry
NPI 1114816634
4204 BROADWAY
New York, NY 10033
(917) 920-2636
✔ PECOSSame address
Vladimir Dvoretsky, O.D.
Optometry
NPI 1336294636
817 W 181ST ST
New York, NY 10033
(212) 923-2020
✔ PECOS✔ Accepts Medicare0.2 mi
Eugene Orloff, OD
Optometry
NPI 1386731974
665 PELHAM PKWY NORTH #202
Bronx, NY 10467
(718) 547-2020
✔ PECOS✔ Accepts Medicare3.6 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 Vistasite Optique Inc's NPI number?

The NPI number for Vistasite Optique Inc is 1578052791. It was assigned to this organization in the NPPES registry on May 2, 2018. The provider is doing business as Vistasite.

Where is Vistasite Optique Inc located?

Vistasite Optique Inc is located at 4204 Broadway, New York, NY 10033. The listed phone number is (917) 261-6100.

What is Vistasite Optique Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ophthalmologic Surgery, with taxonomy code 261QS0132X.

Is Vistasite Optique Inc enrolled in Medicare?

Yes. Vistasite Optique Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Vistasite Optique Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Optometry, reassign their Medicare billing to Vistasite Optique 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. Of these, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Vistasite Optique Inc accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and BlueCross BlueShield of Tennessee list Vistasite Optique 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 Vistasite Optique Inc was last updated on March 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.