Individual provider Active NPI

Paul R Cosenza, O.D.

  • Optometrist
  • Lindenhurst, NY
National Provider Identifier
1275528358
Registry record updated Mar 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV004106-1 Issued in NY
Practice address
651 N Wellwood Ave
Lindenhurst, NY 11757-1635
Phone
(631) 226-2020
Fax
(631) 226-7371
NPI assigned
Sep 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV004106-1 NY Primary

Addresses

Primary practice location

651 N Wellwood Ave
Lindenhurst, NY 11757-1635

Mailing address

651 N Wellwood Ave
Lindenhurst, NY 11757-1635
Phone (631) 226-2020

Other identifiers 1

IdentifierTypeStateIssuer
00880442MedicaidNY

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
I20050103000501 NY Practitioner - Optometry 6800850017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lindyeyecare Optometry PLLCGroup PAC ID 4385893114, 2 clinicians

Practice addresses (Care Compare)

651 N Wellwood Ave
Lindenhurst, NY 11757-1635
Phone (631) 226-2020

651 Wellwood Ave
Lindenhurst, NY 11757-1635

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV004106-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lindyeyecare Optometry PLLC Optometrist CurrentSince Jan 1, 2011 Accepting new patients

Locations

651 Wellwood Ave
Lindenhurst, NY 11757
Phone (631) 226-2020

Organizations & group practices 1

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": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394496000000",
    "number": "1275528358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 N WELLWOOD AVE",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117571635",
            "telephone_number": "631-226-2020",
            "fax_number": "631-226-7371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 N WELLWOOD AVE",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117571635",
            "telephone_number": "631-226-2020",
            "fax_number": "631-226-7371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSENZA",
        "first_name": "PAUL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2014-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV004106-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00880442",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lindenhurst, NY

Sources for this page

Verify at the official NPI Registry.