Active NPI
Mark S Vogel, O.D.
- Optometrist
- East Patchogue, NY
National Provider Identifier
1114915600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TUV003491
- Practice address
- 285 Sills Rd
Suite 4C
East Patchogue, NY 11772-4869 - Phone
- (631) 654-2020
- Fax
- (631) 654-0606
- NPI assigned
- Oct 10, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | TUV003491 | NY | Primary |
Addresses
Primary practice location
285 Sills Rd
Suite 4C
East Patchogue, NY 11772-4869
Mailing address
285 Sills Rd
Suite 4C
East Patchogue, NY 11772-4869
Phone (631) 654-2020
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00338129 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TUV003491 | NY | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mark S. Vogel | Optometrist | Past | Accepting new patients |
| Cardone Family Optometry, PLLC | Optometrist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Optometrist
- East Patchogue, NY
- NPI 1699914135
-
- Optometrist
- Patchogue, NY
- NPI 1669610523
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114915600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "285 SILLS RD",
"address_2": "SUITE 4C",
"city": "EAST PATCHOGUE",
"state": "NY",
"postal_code": "117724869",
"telephone_number": "631-654-2020",
"fax_number": "631-654-0606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "285 SILLS RD",
"address_2": "SUITE 4C",
"city": "EAST PATCHOGUE",
"state": "NY",
"postal_code": "117724869",
"telephone_number": "631-654-2020",
"fax_number": "631-654-0606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VOGEL",
"first_name": "MARK",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "TUV003491",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00338129",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in East Patchogue, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.