NPIMap

Organization Active NPI

Peconic Ophthalmology,PLLC

  • Ophthalmology Physician
  • Riverhead, NY
National Provider Identifier
1043263692
Registry record updated Apr 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
PECONIC OPHTHALMOLOGY,PLLC
Practice address
1228 Roanoke Ave
Riverhead, NY 11901-2740
Phone
(631) 727-5265
Fax
(631) 727-0092
NPI assigned
May 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2008

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

Authorized official

Name
Dr. Louis Donald Pizzarello, M.D.
Title
Owner
Phone
(631) 283-5152

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1228 Roanoke Ave
Riverhead, NY 11901-2740

Mailing address

137 Hampton Rd
Southampton, NY 11968-4923
Phone (631) 283-5152

Other identifiers 1

IdentifierTypeStateIssuer
02407812MedicaidNY

National Provider Directory

National Provider Directory

Locations

1228 Roanoke Ave
Riverhead, NY 11901
Phone (631) 726-5265

137 Hampton Rd
Southampton, NY 11968
Phone (631) 283-5152

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208217600000",
    "number": "1043263692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 HAMPTON RD",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119684923",
            "telephone_number": "631-283-5152",
            "fax_number": "631-283-5161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1228 ROANOKE AVE",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012740",
            "telephone_number": "631-727-5265",
            "fax_number": "631-727-0092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PECONIC OPHTHALMOLOGY,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2008-04-15",
        "status": "A",
        "authorized_official_last_name": "PIZZARELLO",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_middle_name": "DONALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-283-5152",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02407812",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.