Individual provider Active NPI

Tracey Nicole Rosenlicht, OD

  • Optometrist
  • Dix Hills, NY
National Provider Identifier
1174374037
Registry record updated May 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
011154 Issued in NY
Practice address
40 McCulloch Dr
Dix Hills, NY 11746-8328
Phone
(631) 871-5136
NPI assigned
Mar 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 011154 NY Primary

Addresses

Primary practice location

40 McCulloch Dr
Dix Hills, NY 11746-8328

Mailing address

40 McCulloch Dr
Dix Hills, NY 11746-8328
Phone (631) 871-5136

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
I20250923000076 NY Practitioner - Optometry 3274038211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sight Medical Doctors PLLCGroup PAC ID 5991935173, 115 clinicians

Practice addresses (Care Compare)

260 E Middle Country Rd
Suite 201
Smithtown, NY 11787-2925
Phone (631) 265-8780

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011154NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sight Medical Doctors PLLC CurrentSince Sep 1, 2025 Accepting new patients
Sight Medical Doctors PLLC CurrentSince Sep 1, 2025 Accepting new patients

Locations

125 Kennedy Dr
Ste 400
Hauppauge, NY 11788

260 E Middle Country Rd
Ste 102
Smithtown, NY 11787

260 E Middle Country Rd
Ste 109
Smithtown, NY 11787
Phone (631) 361-3577

260 E Middle Country Rd
Ste 201
Smithtown, NY 11787
Phone 6312658780150

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1711584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747526400000",
    "number": "1174374037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 MCCULLOCH DR",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117468328",
            "telephone_number": "631-871-5136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 MCCULLOCH DR",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117468328",
            "telephone_number": "631-871-5136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENLICHT",
        "first_name": "TRACEY",
        "middle_name": "NICOLE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-28",
        "last_updated": "2025-05-18",
        "certification_date": "2025-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "011154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dix Hills, NY

Sources for this page

Verify at the official NPI Registry.