Michael Pennett, M D

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

184913 Issued in NY

Practice address

115 W 29TH St
New York, NY 10001-5106

Phone

(718) 897-3206

NPI assigned

Sep 1, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314835200000",
    "number": "1144501263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7110",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101507110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W 29TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100015106",
            "telephone_number": "718-897-3206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNETT",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-01",
        "last_updated": "2011-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "184913",
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Pennacchia, LCSW
• Shani Pennant, MD
• Michelle Pennasilico
• Melanie F Pennella, RD, CSO, CDN
• Hannah Penner, M.S., CCC-SLP, CBIS
• Alexander Penney, LMSW
• Stephanie Raquel Penney, M.A.
• Vincent M Pennica, AGACNP-BC
• Kersha Pennicott, MD
• Alexandra Pennington

• Ophthalmology Physician in New York, NY
• Providers in New York, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2011; 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.