Individual provider Active NPI

Donne Mangatt, O.D.

  • Optometrist
  • Bronx, NY
National Provider Identifier
1649342163
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV006863-1 Issued in NY
Practice address
2075 Bartow Ave
Bronx, NY 10475-4613
Phone
(718) 320-0049
Fax
(718) 320-4809
NPI assigned
Nov 14, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 TUV006863-1 NY Primary

Addresses

Primary practice location

2075 Bartow Ave
Bronx, NY 10475-4613

Mailing address

118 Crisfield St
# 3
Yonkers, NY 10710-1225
Phone (914) 274-8388

Other identifiers 1

IdentifierTypeStateIssuer
0109445OtherNYGHI

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
I20050214000162 NY Practitioner - Optometry 3779535208 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV006863-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Plaza Optical of Monroe, Inc Optometrist CurrentSince Aug 15, 2024 Accepting new patients

Locations

785 State Route 17M
Monroe, NY 10950
Phone (845) 356-2900

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, 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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649342163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 CRISFIELD ST",
            "address_2": "# 3",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107101225",
            "telephone_number": "914-274-8388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 BARTOW AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104754613",
            "telephone_number": "718-320-0049",
            "fax_number": "718-320-4809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGATT",
        "first_name": "DONNE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006863-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0109445",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.