Individual provider Active NPI

Michele Ross, OD

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1003478009
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
008965 Issued in NY
Practice address
2504 Flatbush Ave
Brooklyn, NY 11234-5128
Phone
(718) 258-2020
Fax
(718) 253-4731
NPI assigned
Jul 1, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 008965 NY Primary

Addresses

Primary practice location

2504 Flatbush Ave
Brooklyn, NY 11234-5128

Mailing address

45 Oceana Dr E Apt 2D
Brooklyn, NY 11235-6677

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191204000126 NY Practitioner - Optometry 5092148106 Reassigns benefits to 3 organizations
I20210315000084 NJ Practitioner - Optometry 5092148106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1075 Easton Ave
Somerset, NJ 08873-1648

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey Optometry PC Optometrist CurrentSince Feb 1, 2021 Accepting new patients
Grand Vision Optometry P.C. Optometrist CurrentSince Nov 1, 2019 Accepting new patients
Bay Ridge Vision Center LLC Optometrist CurrentSince Nov 1, 2019 Accepting new patients
Avenue U Optometry P.C. Optometrist CurrentSince Nov 1, 2019 Accepting new patients

Locations

1075 Easton Ave
Ste 12B
Somerset, NJ 08873

1075 Easton Ave
Ste 1-2
Somerset, NJ 08873
Phone (732) 214-1600

187 Avenue U
Brooklyn, NY 11223
Phone (718) 373-2020

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1003478009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 OCEANA DR E APT 2D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 FLATBUSH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112345128",
            "telephone_number": "718-258-2020",
            "fax_number": "718-253-4731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "MICHELE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-01",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "008965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.