Constadina Manettas, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

009253 Issued in NY

Practice address

1456 Fulton St
Brooklyn, NY 11216-2505

Phone

(718) 636-4500

NPI assigned

Sep 10, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

State University of New York - State College Optometry, 2020

Medicare assignment

May accept Medicare assignment

Group practices

Bedford Stuyvesant Family Health Center IncGroup PAC ID 0143361238, 31 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DFDFAA

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.

• Bedford Stuyvesant Family Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Brooklyn, NY
  • NPI 1033178561
  Medicare reassignment Care Compare group NPD
• Bedford Stuyvesant Family Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Brooklyn, NY
  • NPI 1528836590
  NPD

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1245845973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 E 116TH ST APT 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100291618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1456 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112162505",
            "telephone_number": "718-636-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANETTAS",
        "first_name": "CONSTADINA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-10",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "009253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prabhjot Manes, M.D.
• Rachel Lynn Manes, LCSW
• Chaya Esther Maness, RN
• Moshe Maness
• Annabella Marie Manetta, DDS
• Nancy S Maneus
• Tatyana Manevich, OPTICIAN
• Jaime Rachel Mangalathu, MD
• Matthew Stephen Manganaro, M.D.
• Lynn Manganiello, DO

• Optometrist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.