Massapequa Optometric Care, P.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

VUT005276 Issued in NY

Legal business name

MASSAPEQUA OPTOMETRIC CARE, P.C.

Practice address

532 Broadway
Massapequa, NY 11758

Phone

(516) 798-2635

Fax

(516) 798-0896

NPI assigned

May 5, 2006

Organization subpart

No

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

Authorized official

Name

John A Facchin, O.D.NPI 1659336055

Title

President

Phone

(516) 798-2635

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

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

• John A Facchin, OD

  • Optometrist
  • Massapequa, NY
  • NPI 1659336055
  Medicare reassignment Care Compare group NPD Authorized official
• David Lane Leibstein, O.D.

  • Optometrist
  • Massapequa, NY
  • NPI 1598714321
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566345600000",
    "number": "1073562310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "532 BROADWAY",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585004",
            "telephone_number": "516-798-2635",
            "fax_number": "516-798-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "532 BROADWAY",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "11758",
            "telephone_number": "516-798-2635",
            "fax_number": "516-798-0896"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Massapequa",
            "state": "NY",
            "postal_code": "117584905",
            "country_code": "US",
            "telephone_number": "516-798-2635",
            "fax_number": "516-798-0896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MASSAPEQUA OPTOMETRIC CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2019-08-21",
        "status": "A",
        "authorized_official_last_name": "FACCHIN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-798-2635",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "VUT005276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massapequa Neurologic,PC
• Massapequa Podiatry Associates, P.C.
• Massapequa Ufsd
• Catherine Mastricovo
• Marialeen Masucci-Martorella, LCSW-R,BCD
• Scott Mateer, D.D.S

• Optometrist in Massapequa, NY
• Providers in Massapequa, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.