Edward John Moylan, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV004922-1 Issued in NY

Practice address

537 Patchogue Road
Port Jefferson Station, NY 11776

Phone

(631) 642-2020

Fax

(631) 642-3938

NPI assigned

Nov 28, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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 1

Specialty

Optometry

Education

Pennsylvania College of Optometry, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Edward J Moylan OD PCGroup PAC ID 8224075288, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

65.83 of 100Reported as individual

Quality

31.67

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Edward J Moylan OD PC

  • Optometrist
  • Port Jefferson Station, NY
  • NPI 1043408958
  Medicare reassignment Care Compare group NPD Authorized official
• Alfred J. Cossari, M.D., P.C.

  • Ophthalmology Physician
  • Port Jefferson, NY
  • NPI 1417250135
  NPD (past)

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594080000000",
    "number": "1063588424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 OLD HOMESTEAD RD",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771108",
            "telephone_number": "631-476-7099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 PATCHOGUE ROAD",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "11776",
            "telephone_number": "631-642-2020",
            "fax_number": "631-642-3938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYLAN",
        "first_name": "EDWARD",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV004922-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Morgan, LMSW
• Robert Mormando, D.O.
• Jeanne Marie Morris-Foley, NPP CS CASAC
• Juleesa Jasmine Mosley, LPN
• Hillary Caroline Moss
• Blaire Muller
• Andrew Mulligan, O.D.
• Dianne Munz, RN
• Alyssa Murphy, NP
• Duran Thomas Murphy

• Optometrist in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.