Individual provider Active NPI

Michele Desjardins Thompson, O.D.

  • Optometrist
  • Staten Island, NY
National Provider Identifier
1245582154
Registry record updated Oct 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
005282 Issued in NY
Practice address
4338 Amboy Rd
Staten Island, NY 10312-3820
Phone
(718) 494-1319
NPI assigned
Oct 3, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2012

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 005282 NY Primary
Optometrist 152W00000X 27TO00089800 NJ
Optometrist 152W00000X 27OA00541000 NJ
Optometrist 152W00000X 27OM00090800 NJ

Addresses

Primary practice location

4338 Amboy Rd
Staten Island, NY 10312-3820

Mailing address

101 W River Rd
Rumson, NJ 07760-1124
Phone (732) 345-0247

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20150701000251 NJ Practitioner - Optometry 2668784885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erin M. Curtis, O.D., P.C.Group PAC ID 6103905773, 3 clinicians

Practice addresses (Care Compare)

41 E Front St
Red Bank, NJ 07701-1974
Phone (732) 741-0170

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OM00090800NJMDOptometrist
27TO00089800NJMDOptometrist
005282NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Erin M. Curtis OD PC Optometrist CurrentSince May 19, 2015 Accepting new patients
Richmond Optometry PC Optometrist Past Accepting new patients
The Perfect Eye Inc Past Accepting new patients

Organizations & group practices 3

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": "1349222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349222400000",
    "number": "1245582154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W RIVER RD",
            "city": "RUMSON",
            "state": "NJ",
            "postal_code": "077601124",
            "telephone_number": "732-345-0247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4338 AMBOY RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103123820",
            "telephone_number": "718-494-1319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "MICHELE",
        "middle_name": "DESJARDINS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-03",
        "last_updated": "2012-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "005282",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27TO00089800",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00541000",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OM00090800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.