Vincent Michael Magliocco, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

GA2071 Issued in GA

Practice address

2230 Towne Lake Pkwy
Building 700 Suite 100
Woodstock, GA 30189-5540

Phone

(770) 591-3511

Fax

(770) 591-3752

NPI assigned

May 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Dr. Daniel D. Gottlieb Optometrist, PC

  • Low Vision Rehabilitation Optometrist
  • Alpharetta, GA
  • NPI 1720285307
  NPD (past)

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358294400000",
    "number": "1194771766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 TOWNE LAKE PKWY",
            "address_2": "BUILDING 700 SUITE 100",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301895540",
            "telephone_number": "770-591-3511",
            "fax_number": "770-591-3752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 TOWNE LAKE PKWY",
            "address_2": "BUILDING 700 SUITE 100",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301895540",
            "telephone_number": "770-591-3511",
            "fax_number": "770-591-3752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGLIOCCO",
        "first_name": "VINCENT",
        "middle_name": "MICHAEL",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2013-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "GA2071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1194771766",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PCAN",
            "identifier": "202I415396",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luxottica of America Inc.
• M.E.M. Medical Services, P.C.
• Larry Tufani Mabine, MD
• Staci Mackay-Mercer, CO
• Laura Madinger, MED
• Magnolia Grace Homecare LLC
• Padmini Amanda Mahadeo, COTA
• Redah Z Mahmood, MD
• Taylor James Maida, PT, DPT
• Adetola Makanjuola

• Optometrist in Woodstock, GA
• Providers in Woodstock, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.