Active NPI
Angelo Tocco, O.D.
- Optometrist
- Grosse Pointe, MI
National Provider Identifier
1043380553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901002831
- Practice address
- 20845 Mack Ave
Grosse Pointe, MI 48236-1456 - Phone
- (313) 885-4987
- Fax
- (313) 885-4198
- NPI assigned
- Nov 9, 2006
- Last updated
- Apr 9, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901002831 | MI | Primary |
| Corneal and Contact Management Optometrist | 152WC0802X | 4901002831 | MI | |
| Pediatric Optometrist | 152WP0200X | 4901002831 | MI | |
| Sports Vision Optometrist | 152WS0006X | 4901002831 | MI |
Addresses
Primary practice location
20845 Mack Ave
Grosse Pointe, MI 48236-1456
Mailing address
20845 Mack Ave
Grosse Pointe, MI 48236-1456
Phone (313) 885-4987
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 382191872 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071005000758 | MI | Practitioner - Optometry | 0749375665 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4901002831 | MI | MD | Pediatric Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Associated Eye Specialists of Troy, PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Yaldo Eye Center
- Ophthalmology Physician
- Saint Clair Shores, MI
- NPI 1982734406
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1239235200000",
"number": "1043380553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20845 MACK AVE",
"city": "GROSSE POINTE",
"state": "MI",
"postal_code": "482361456",
"telephone_number": "313-885-4987",
"fax_number": "313-885-4198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20845 MACK AVE",
"city": "GROSSE POINTE",
"state": "MI",
"postal_code": "482361456",
"telephone_number": "313-885-4987",
"fax_number": "313-885-4198"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOCCO",
"first_name": "ANGELO",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-09",
"last_updated": "2009-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901002831",
"primary": true
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "MI",
"license": "4901002831",
"primary": false
},
{
"code": "152WP0200X",
"taxonomy_group": "",
"desc": "Optometrist, Pediatrics",
"state": "MI",
"license": "4901002831",
"primary": false
},
{
"code": "152WS0006X",
"taxonomy_group": "",
"desc": "Optometrist, Sports Vision",
"state": "MI",
"license": "4901002831",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "382191872",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Grosse Pointe, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.