Active NPI
Michael Victor Gerlan, O.D.
- Optometrist
- White Plains, NY
National Provider Identifier
1275698979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TUV4578-1
- Practice address
- 99 Mamaroneck Ave
White Plains, NY 10601-5208 - Phone
- (914) 948-6969
- Fax
- (914) 948-6969
- NPI assigned
- Dec 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | TUV4578-1 | NY | Primary |
Addresses
Primary practice location
99 Mamaroneck Ave
White Plains, NY 10601-5208
Mailing address
99 Mamaroneck Ave
White Plains, NY 10601-5208
Phone (914) 948-6969
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01212188 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TUV4578-1 | NY | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208822400000",
"number": "1275698979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 MAMARONECK AVE",
"city": "WHITE PLAINS",
"state": "NY",
"postal_code": "106015208",
"telephone_number": "914-948-6969",
"fax_number": "914-948-6969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99 MAMARONECK AVE",
"city": "WHITE PLAINS",
"state": "NY",
"postal_code": "106015208",
"telephone_number": "914-948-6969",
"fax_number": "914-948-6969"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERLAN",
"first_name": "MICHAEL",
"middle_name": "VICTOR",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-25",
"last_updated": "2008-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "TUV4578-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01212188",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in White Plains, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.