Individual provider Active NPI

Michael Pittelli, OD

  • Optometrist
  • Massapequa, NY
National Provider Identifier
1225192719
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6251 Issued in NY
Practice address
532 Broadway
Massapequa, NY 11758-5004
Phone
(516) 798-2635
NPI assigned
Dec 20, 2006
Last updated
Jun 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6251 NY Primary
Optometrist 152W00000X 1337 AZ

Addresses

Primary practice location

532 Broadway
Massapequa, NY 11758-5004

Mailing address

532 Broadway
Massapequa, NY 11758-5004
Phone (516) 798-2635

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
I20190910000927 NY Practitioner - Optometry 0840270724 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
200 West Optics LLCGroup PAC ID 5395144380, shared by 2 NPIs, 38 clinicians

Practice addresses (Care Compare)

1765 Central Park Ave
Yonkers, NY 10710-2828
Phone (914) 961-1004

532 Broadway
Massapequa, NY 11758-5004
Phone (516) 798-2635

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1337AZMDOptometrist
6251NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore Optometric Associates, PC Optometrist CurrentSince Nov 14, 2024 Accepting new patients
Empire Vision Center, Inc CurrentSince Jul 31, 2019 Accepting new patients
Empire Vision Center Inc Optometrist CurrentSince Jul 31, 2019 Accepting new patients
Tom Sowash OD & Associates PC Optometrist Past Accepting new patients
Visionworks Inc Past Accepting new patients
200 West Optics, LLC Optometrist PastSince Nov 14, 2024 Accepting new patients

Locations

202 Broadway
Amityville, NY 11701
Phone (631) 264-3937

2680 Delaware Ave
Ste C
Buffalo, NY 14216
Phone (716) 873-1241

560 Troy Schenectady Rd
#7
Latham, NY 12110
Phone (518) 783-0090

1930 South Rd
#105
Poughkeepsie, NY 12601
Phone (845) 298-3200

2590 W Ridge Rd
Rochester, NY 14626
Phone (585) 227-7150

2921 Erie Blvd E
Syracuse, NY 13224
Phone (315) 446-3145

Organizations & group practices 6

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1225192719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "532 BROADWAY",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585004",
            "telephone_number": "516-798-2635",
            "fax_number": "631-598-4496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "532 BROADWAY",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585004",
            "telephone_number": "516-798-2635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITTELLI",
        "first_name": "MICHAEL",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "6251",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1337",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa, NY

Sources for this page

Verify at the official NPI Registry.