Individual provider Active NPI

Richard James Madonna, O.D.

  • Optometrist
  • New York, NY
National Provider Identifier
1194798637
Registry record updated Dec 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
VUT4590 Issued in NY
Practice address
33 W 42ND St
Suny State College of Optometry
New York, NY 10036-8005
Phone
(212) 938-4060
NPI assigned
Feb 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X VUT4590 NY Primary

Addresses

Primary practice location

33 W 42ND St
Suny State College of Optometry
New York, NY 10036-8005

Mailing address

4 Lagoon LN
Haverstraw, NY 10927-2101
Phone (845) 786-3340

Other identifiers 1

IdentifierTypeStateIssuer
00244528MedicaidNY

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
I20120112000030 NY Practitioner - Optometry 2567639735 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.46 of 100Reported as group
Quality
73.89
Promoting interoperability
89
Improvement activities
40
Cost
75.72

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004590NYMDMental Health Counselor
VUT4590NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
State of New York Comptrollers Office CurrentSince Jun 2, 1977 Accepting new patients
State of New York Comptrollers Office Optometrist CurrentSince Jun 2, 1977 Accepting new patients

Locations

33 W 42nd St
#10
New York, NY 10036
Phone (212) 780-4930

33 W 42nd St
Fl 10
New York, NY 10036
Phone (212) 780-4930

University Eye Ctr
New York, NY 10087

33 W 42nd St
New York, NY 10036
Phone (212) 780-4930

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292371200000",
    "number": "1194798637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 LAGOON LN",
            "city": "HAVERSTRAW",
            "state": "NY",
            "postal_code": "109272101",
            "telephone_number": "845-786-3340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 W 42ND ST",
            "address_2": "SUNY STATE COLLEGE OF OPTOMETRY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100368005",
            "telephone_number": "212-938-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADONNA",
        "first_name": "RICHARD",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2010-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "VUT4590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00244528",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.