Individual provider Active NPI

Madeline Cohen, O.D.

  • Optometrist
  • Huntington, NY
National Provider Identifier
1184693335
Registry record updated Jan 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
005551 Issued in NY
Practice address
755 Park Ave
Suite 100
Huntington, NY 11743-3972
Phone
(631) 223-0400
Fax
(631) 421-2689
NPI assigned
Mar 17, 2006
Last updated
Jan 22, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 005551 NY Primary

Addresses

Primary practice location

755 Park Ave
Suite 100
Huntington, NY 11743-3972

Mailing address

19 Bark LN
Northport, NY 11768-3301
Phone (631) 262-0479

Other identifiers 1

IdentifierTypeStateIssuer
02632442MedicaidNY

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

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421884800000",
    "number": "1184693335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BARK LN",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117683301",
            "telephone_number": "631-262-0479",
            "fax_number": "631-262-0479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 PARK AVE",
            "address_2": "SUITE 100",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117433972",
            "telephone_number": "631-223-0400",
            "fax_number": "631-421-2689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "MADELINE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2015-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "005551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02632442",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2015; 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.