Peter Joseph Micca, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV004870 Issued in NY

Practice address

2100 Clinton Ave S
Rochester, NY 14618-2616

Phone

(585) 244-6011

Fax

(585) 244-0236

NPI assigned

Jan 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: petermiccaod@drkazdan2020.direct.eyemdemr.com

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.

• Cary a Kazdan OD PLLC

  • Optometrist
  • Rochester, NY
  • NPI 1972726321
  Medicare reassignment NPD
• Empire Vision Center Inc

  dba Davis Vision

  • Optometrist
  • Syracuse, NY
  • NPI 1750358826
  Medicare reassignment NPD
• Empire Vision Center, Inc

  dba Visionworks

  • Eyewear Supplier
  • Attleboro, MA
  • NPI 1730635582
  NPD
• Rochester General Hospital

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1063531929
  NPD (past)

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408406400000",
    "number": "1376513366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 CLINTON AVE S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146182616",
            "telephone_number": "585-244-6011",
            "fax_number": "585-244-0236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 CLINTON AVE S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146182616",
            "telephone_number": "585-244-6011",
            "fax_number": "585-244-0236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICCA",
        "first_name": "PETER",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2014-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV004870",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NY",
            "license": "TUV004870",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "P011004870",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caitlin Meza, MD
• David J Mezynski, LMSW
• Lijun Mi, MD
• Serajus Salekin Miah, MD
• Ayesa N Mian, M.D.
• Wendy Sue Micca, OPTICIAN
• Madeline Rissa Micciche, LCSW-R
• Anthony Michael Miceli, PA
• Juliana Rosemarie Miceli, PT, DPT
• Nicole Miceli

• Optometrist in Rochester, NY
• Providers in Rochester, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.