Individual provider Active NPI

Alice M Mann, O.D.

  • Optometrist
  • Oakland Gardens, NY
National Provider Identifier
1376510388
Registry record updated Dec 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
VUT004899 Issued in NY
Practice address
22104 Horace Harding Expy
Oakland Gardens, NY 11364-2333
Phone
(718) 225-7400
Fax
(718) 225-7606
NPI assigned
Mar 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X VUT004899 NY Primary

Addresses

Primary practice location

22104 Horace Harding Expy
Oakland Gardens, NY 11364-2333

Mailing address

2453 Jericho Tpke
Garden City Park, NY 11040-4710
Phone (516) 746-3836

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
I20110615000848 NY Practitioner - Optometry 5991982159 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optyx LLCGroup PAC ID 6406207737, 10 clinicians

Practice addresses (Care Compare)

7947 Jericho Tpke
Unit a
Woodbury, NY 11797-1264
Phone (516) 921-2040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
VUT004899NYMDOptometrist
004899NYMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Optyx LLC Optometrist CurrentSince Oct 28, 2023 Accepting new patients
Optyx LLC PastSince Oct 28, 2023 Accepting new patients

Locations

312 Springfield Ave
Berkeley Hts, NJ 07922
Phone (908) 336-5661

2443 Jericho Tpke
Garden City Park, NY 11040
Phone (516) 746-3836

10095 Main Rd
Mattituck, NY 11952
Phone (631) 213-4499

2384 Broadway
New York, NY 10024
Phone (212) 724-0850

1229 Wantagh Ave
Wantagh, NY 11793
Phone (516) 221-2220

7947 Jericho Tpke
Unit A
Woodbury, NY 11797
Phone (516) 921-2040

Organizations & group practices 2

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198713600000",
    "number": "1376510388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2453 JERICHO TPKE",
            "city": "GARDEN CITY PARK",
            "state": "NY",
            "postal_code": "110404710",
            "telephone_number": "516-746-3836",
            "fax_number": "516-746-3837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22104 HORACE HARDING EXPY",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "113642333",
            "telephone_number": "718-225-7400",
            "fax_number": "718-225-7606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "ALICE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2007-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "VUT004899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland Gardens, NY

Sources for this page

Verify at the official NPI Registry.