Lisa Maria Modesto, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV007078 Issued in NY

Practice address

10933 71St Rd
Suite 2 C
Forest Hills, NY 11375-4867

Phone

(718) 261-3366

NPI assigned

Aug 18, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jaclyn Benzoni OD PCGroup PAC ID 8527346246, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Jaclyn Benzoni OD PC

  • Optometrist
  • Merrick, NY
  • NPI 1538617790
  Medicare reassignment Care Compare group NPD
• Empire Vision Center Inc

  • Optometrist
  • Syracuse, NY
  • NPI 1750358826
  Medicare reassignment NPD
• Maayan Keshet MD PC

  • Ophthalmologic Surgery Clinic/Center
  • New York, NY
  • NPI 1396164216
  Medicare reassignment
• Empire Vision Center, Inc

  • Eyewear Supplier
  • Attleboro, MA
  • NPI 1730635582
  NPD
• Mark D Fromer, MD PC

  • Ophthalmology Physician
  • Forest Hills, NY
  • NPI 1649306218
  NPD (past)

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204070400000",
    "number": "1598879637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 E 20TH ST APT 4E",
            "address_2": "APT. 4 E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100091403",
            "telephone_number": "917-843-9639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10933 71ST RD",
            "address_2": "SUITE 2 C",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754867",
            "telephone_number": "718-261-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODESTO",
        "first_name": "LISA",
        "middle_name": "MARIA",
        "name_prefix": "Miss",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2008-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MM Medical Service PC
• MNB Medical PC
• Mobilecare Physical Therapy, PC
• Modern Dental of Queens P.C.
• Dylicia Modeste- George
• Behnam Y Moghadasian, D.D.S
• Angela Madison Mohamed, LMSW
• Mahmoud Diab Mohamed, DPT, PHD
• Rehab M Mohamed
• Hailei Mohammed

• Optometrist in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.