Active NPI
Middletown Eye Care OD PC
- Optometrist
- Middletown, NY
National Provider Identifier
1255084729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- MIDDLETOWN EYE CARE OD PC
- Practice address
- 1 North Galleria Drive Ste 26
Middletown, NY 10941-3018 - Phone
- (845) 692-0709
- NPI assigned
- Feb 3, 2022
- Organization subpart
- Yes
- Parent organization
- MIDDLETOWN EYE CARE OD PC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Grace Matos, OD
- Title
- Optometrist
- Phone
- (845) 692-0709
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary |
Addresses
Primary practice location
1 North Galleria Drive Ste 26
Middletown, NY 10941-3018
Mailing address
1 North Galleria Drive Ste 26
Middletown, NY 10941-3018
Phone (845) 692-0709
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760683437 | Medicaid | NY | |
| 1700088481 | Medicaid | NY |
National Provider Directory
National Provider Directory- Part of
- Middletown Eye Care OD PC
Locations
1 N Galleria Dr
Ste 26
Middletown, NY 10941
Phone (845) 692-0504
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643846400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1643846400000",
"number": "1255084729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 NORTH GALLERIA DRIVE STE 26",
"city": "MIDDLETOWN",
"state": "NY",
"postal_code": "109413018",
"telephone_number": "845-692-0709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 NORTH GALLERIA DRIVE STE 26",
"city": "MIDDLETOWN",
"state": "NY",
"postal_code": "109413018",
"telephone_number": "845-692-0709"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MIDDLETOWN EYE CARE OD PC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MIDDLETOWN EYE CARE OD PC",
"enumeration_date": "2022-02-03",
"last_updated": "2022-02-03",
"certification_date": "2022-02-03",
"status": "A",
"authorized_official_last_name": "MATOS",
"authorized_official_first_name": "GRACE",
"authorized_official_title_or_position": "OPTOMETRIST",
"authorized_official_telephone_number": "845-692-0709",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1760683437",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1700088481",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Middletown, NY
- Middletown Community Health Center Inc
- Middletown Community Health Center Inc
- Middletown Community Health Center, Inc.
- Middletown Dental Associates (Middletown Dental Asssociates)
- Middletown Dental PC (middletown dental group)
- Middletown Health Wellness Chiropractic PC
- Middletown LTC Pharmacy LLC (Hudson Regional LTC Pharmacy)
- Middletown Medical PC
- Middletown Medical PC
- Middletown Medical PC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.