Individual provider Active NPI

Christopher John Vissicchio, OD

  • Optometrist
  • Rockville Centre, NY
National Provider Identifier
1295412526
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV009775-01 Issued in NY
Practice address
313 Merrick Rd
Rockville Centre, NY 11570-5325
Phone
(516) 536-1031
NPI assigned
Jun 28, 2023
Last updated
Jun 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV009775-01 NY Primary

Addresses

Primary practice location

313 Merrick Rd
Rockville Centre, NY 11570-5325

Mailing address

2706 Riverside Dr
Wantagh, NY 11793-4624
Phone (516) 732-7589

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
I20230801004286 NY Practitioner - Optometry 0840651238 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Stream Optometric Services PCGroup PAC ID 7719271162, 3 clinicians

Practice addresses (Care Compare)

5 Sunrise PLZ
Suite 101
Valley Stream, NY 11580-6130
Phone (516) 825-7455

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV009775-01NYMDOptometrist
009775NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Stream Optometric Services PC Optometrist CurrentSince Nov 1, 2024 Accepting new patients
Empire Vision Center, Inc CurrentSince Jul 11, 2023 Accepting new patients
Empire Vision Center Inc Optometrist CurrentSince Jul 11, 2023 Accepting new patients
Empire Vision Center Inc Optometrist PastSince Jul 2, 2023 Accepting new patients

Locations

2680 Delaware Ave
Ste C
Buffalo, NY 14216
Phone (716) 873-1241

560 Troy Schenectady Rd
#7
Latham, NY 12110
Phone (518) 783-0090

1930 South Rd
#105
Poughkeepsie, NY 12601
Phone (845) 298-3200

2590 W Ridge Rd
Rochester, NY 14626
Phone (585) 227-7150

313 Merrick Rd
Rockville Centre, NY 11570
Phone (516) 536-1031

2921 Erie Blvd E
Syracuse, NY 13224
Phone (315) 446-3145

5 Sunrise Plz
Ste 101
Valley Stream, NY 11580
Phone (516) 825-7455

Interoperability endpoints

  • Direct secure messaging: cvissicchio@valleystreamos.eyefinity-direct.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1687910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1295412526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2706 RIVERSIDE DR",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117934624",
            "telephone_number": "516-732-7589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 MERRICK RD",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115705325",
            "telephone_number": "516-536-1031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISSICCHIO",
        "first_name": "CHRISTOPHER",
        "middle_name": "JOHN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-28",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV009775-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

Verify at the official NPI Registry.