Individual provider Active NPI

Jacob Samuel Morra, OD

  • Optometrist
  • New York, NY
National Provider Identifier
1114656592
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
390200000X Issued in NY
Practice address
7 7TH Ave
New York, NY 10011-6628
Phone
(646) 973-3400
NPI assigned
Jun 9, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 390200000X NY Primary

Addresses

Primary practice location

7 7TH Ave
New York, NY 10011-6628

Mailing address

7 7TH Ave
New York, NY 10011-6628
Phone (646) 973-3400

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
I20240126003210 NY Practitioner - Optometry 0446603351 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

7 7TH Ave
New York, NY 10011-6628
Phone (516) 734-8500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009682NYMDMental Health Counselor
390200000XNYMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Dec 3, 2023 Accepting new patients

Locations

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

7 7th Ave
New York, NY 10011
Phone (646) 973-3400

100 E 77th St
New York, NY 10075
Phone (212) 434-2606

300 Community Dr
Plandome, NY 11030

Interoperability endpoints

  • Direct secure messaging: jmorra25916@northwell.direct-ci.com
  • Direct secure messaging: jmorra1@northwellhealth.intellechartdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1654732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1114656592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 7TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100116628",
            "telephone_number": "646-973-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 7TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100116628",
            "telephone_number": "646-973-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRA",
        "first_name": "JACOB",
        "middle_name": "SAMUEL",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-09",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "390200000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.