Individual provider Active NPI

Raymond E Mariani, O.D.

  • Optometrist
  • Rockville Centre, NY
National Provider Identifier
1205831724
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T005270 Issued in NY
Practice address
2000 N Village Ave
Ste 402
Rockville Centre, NY 11570-1001
Phone
(516) 766-2519
Fax
(516) 766-3714
NPI assigned
Jun 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T005270 NY Primary

Addresses

Primary practice location

2000 N Village Ave
Ste 402
Rockville Centre, NY 11570-1001

Mailing address

825 East Gate Blvd
Ste 111
Garden City, NY 11530
Phone (516) 804-5200

Other identifiers 1

IdentifierTypeStateIssuer
01350825MedicaidNY

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
I20050310000146 NY Practitioner - Optometry 1951355106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ophthalmic Consultants of Long IslandGroup PAC ID 8022909076, 107 clinicians

Practice addresses (Care Compare)

2000 N Village Ave
Rockville Centre, NY 11570-1078
Phone (516) 766-2519

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005270NYMDChiropractor
T005270NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ophthalmic Consultants of Long Island CurrentSince Jan 1, 2014 Accepting new patients
Ophthalmic Consultants of Long Island Past Accepting new patients
Ophthalmic Consultants of Long Island Past Accepting new patients

Locations

4 Technology Dr
Ste 150
East Setauket, NY 11733
Phone (631) 941-1400

825 E Gate Blvd
Ste 111
Garden City, NY 11530
Phone (516) 804-5200

711 Stewart Ave
Ste 160
Garden City, NY 11530
Phone (516) 500-4200

450 Endo Blvd
Garden City South, NY 11530
Phone (516) 832-8000

189 Forest Ave
Ste 2C
Glen Cove, NY 11542
Phone (516) 674-3000

755 Park Ave
Ste 1
Huntington, NY 11743

125 Oakland Ave
Ste 101
Port Jefferson, NY 11777
Phone (631) 828-7100

2000 N Village Ave
Ste 402
Rockville Ctr, NY 11570
Phone (516) 766-2519

2000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1777

2000 N Village Ave
#13202
Rockville Ctr, NY 11570
Phone (516) 766-2519

Interoperability endpoints

  • Direct secure messaging: raymond.marianiod.p1@direct.ocli.nextgenshare.com

Organizations & group practices 4

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": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1205831724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 EAST GATE BLVD",
            "address_2": "STE 111",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "11530",
            "telephone_number": "516-804-5200",
            "fax_number": "516-240-6540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 N VILLAGE AVE",
            "address_2": "STE 402",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115701001",
            "telephone_number": "516-766-2519",
            "fax_number": "516-766-3714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIANI",
        "first_name": "RAYMOND",
        "middle_name": "E",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "T005270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01350825",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

Verify at the official NPI Registry.