Individual provider Active NPI

Mark S Vogel, O.D.

  • Optometrist
  • East Patchogue, NY
National Provider Identifier
1114915600
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV003491 Issued in NY
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

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 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

IdentifierTypeStateIssuer
00338129MedicaidNY

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

LicenseStateTypeSpecialty
TUV003491NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mark S. Vogel Optometrist PastSince Jul 1, 1986 Accepting new patients
Cardone Family Optometry, PLLC Optometrist PastSince Jul 1, 2009 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.

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.

Verify at the official NPI Registry.