Port Jefferson Opticians Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PORT JEFFERSON OPTICIANS INC

Practice address

208 Route 112 Ste 2
Port Jefferson Station, NY 11776-1013

Phone

(631) 331-0600

Fax

(631) 331-0809

NPI assigned

Apr 3, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Paul Mastrorocco, OPTICIANNPI 1801041843

Title

President/Optician

Phone

(631) 331-0600

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Brookhaven Opticians Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul Mastrorocco, DISPENSING OPTICIAN

  • Optician
  • Port Jefferson Station, NY
  • NPI 1801041843
  NPD Authorized official

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631836800000",
    "number": "1154443158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 ROUTE 112 STE 2",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761013",
            "telephone_number": "631-331-0600",
            "fax_number": "631-331-0809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 ROUTE 112 STE 2",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761013",
            "telephone_number": "631-331-0600",
            "fax_number": "631-331-0809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORT JEFFERSON OPTICIANS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A",
        "authorized_official_last_name": "MASTROROCCO",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT/OPTICIAN",
        "authorized_official_telephone_number": "631-331-0600",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OPTICIAN"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01934578",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "portjefferson@brookhavenopticians.com",
            "affiliation": "N",
            "endpointDescription": "Office email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Office email",
            "address_1": "208 Route 112 Ste 2",
            "city": "Port Jefferson Station",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117761013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Brookhaven Opticians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maya Ponzio
• Port Jeff Medical Care, PC
• Port Jefferson ASC, LLC
• Port Jefferson Internal Medicine Assoc
• Port Jefferson Medical Care Wellness PLLC
• Port Jefferson Pediatrics
• Port Jefferson Physical Therapy PC
• Port Jefferson Psychological & Vocational P.C.
• Deidre M Postupack, PT
• Michelle Prescia

• Durable Medical Equipment & Medical Supplies in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Durable Medical Equipment & Medical Supplies in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.