Individual provider Active NPI

Edward Deneve, O.D.

  • Optometrist
  • Bellport, NY
National Provider Identifier
1114074945
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6097TUV Issued in NY
Practice address
5 Bellport LN
Bellport, NY 11713-2705
Phone
(631) 286-4014
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6097TUV NY Primary

Addresses

Primary practice location

5 Bellport LN
Bellport, NY 11713-2705

Mailing address

5 Bellport LN
Bellport, NY 11713-2705

Other identifiers 7

IdentifierTypeStateIssuer
864OtherNYSTORE
66599326OtherNYPROVIDER
50593OtherNYPROVIDER
7182561OtherNYPROVIDER
V73OtherNYSTORE
157939OtherNYPROVIDER
163OtherNYPROVIDER

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070621000626 NY Practitioner - Optometry 0446359012 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

415 Commack Rd
Suite 2B
Deer Park, NY 11729-4508
Phone (631) 392-0711

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6097TUVNYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lucien Eyes, Inc. Optometrist Current Accepting new patients
Sightrite Inc Optometrist CurrentSince Aug 24, 2018 Accepting new patients
Eye Care Vision Optometry P.C. Optometrist CurrentSince Apr 3, 2024 Accepting new patients

Locations

5 Bellport Ln
Bellport, NY 11713
Phone (631) 286-4014

267 Broadway
Fl 2
Brooklyn, NY 11211
Phone (716) 912-5877

1526 New Haven Ave
Far Rockaway, NY 11691
Phone (718) 471-7200

7144 Yellowstone Blvd
Forest Hills, NY 11375
Phone (718) 544-4300

260 Christopher Ln
Ste 102A
Staten Island, NY 10314
Phone (914) 370-4892

918 James St
Syracuse, NY 13203
Phone (315) 474-1561

134 Great East Neck Rd
West Babylon, NY 11704
Phone (631) 321-3850

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114074945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BELLPORT LN",
            "city": "BELLPORT",
            "state": "NY",
            "postal_code": "117132705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 BELLPORT LN",
            "city": "BELLPORT",
            "state": "NY",
            "postal_code": "117132705",
            "telephone_number": "631-286-4014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENEVE",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "6097TUV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STORE",
            "identifier": "864",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER",
            "identifier": "66599326",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER",
            "identifier": "50593",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER",
            "identifier": "7182561",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STORE",
            "identifier": "V73",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER",
            "identifier": "157939",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER",
            "identifier": "163",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellport, NY

Sources for this page

Verify at the official NPI Registry.