Michelle Renee Packles, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

225522 Issued in NY

Practice address

37 Clock Tower LN
Old Westbury, NY 11568-1003

Phone

(516) 626-1340

NPI assigned

Jul 26, 2012

Last updated

Jul 26, 2012By the provider in NPPES

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

State University of New York Downstate Medical Center, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SBH Physicians PCGroup PAC ID 3072798941, 178 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Barnabas Hospital Hospital, Bronx, NY, CCN 330399

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: michellepackles@mai.allscriptsdirect.net
• Direct secure messaging: mpackles19556@sbhny.direct-ci.net

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.

• SBH Physicians, PC

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1740595917
  Medicare reassignment Care Compare group NPD
• Bronxcare Health System

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1245390855
  Medicare reassignment NPD
• Icahn School of Medicine at Mount Sinai

  dba Ophthalmology Department of Mount Sinai

  • Ophthalmology Physician
  • New York, NY
  • NPI 1437421252
  Medicare reassignment NPD
• University Physicians of Brooklyn, Inc.

  dba Downstate Health Physicians

  • Ophthalmology Physician
  • Brooklyn, NY
  • NPI 1497709901
  Medicare reassignment NPD
• Bronxcare Health System

  • Ophthalmology Physician
  • Bronx, NY
  • NPI 1548310758
  NPD
• Bronxcare Health System

  • Methadone Clinic
  • Bronx, NY
  • NPI 1801428222
  NPD
• Icahn School of Medicine at Mount Sinai

  dba New York Eye & Ear Optical Shop

  • Eyewear Supplier
  • New York, NY
  • NPI 1760227466

  Ophthalmology

  NPD
• Maimonides Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1093777492
  NPD
• SBH Physicians, PC

  • Pediatrics Physician
  • Bronx, NY
  • NPI 1457665937
  NPD
• University Physicians of Brooklyn, Inc.

  dba Downstate Health Physicians

  • Child & Adolescent Psychiatry Physician
  • Brooklyn, NY
  • NPI 1689715476
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Barnabas Hospital

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1548367873
  Care Compare affiliation

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

{
    "created_epoch": "1343260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343260800000",
    "number": "1679829758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 CLOCK TOWER LN",
            "city": "OLD WESTBURY",
            "state": "NY",
            "postal_code": "115681003",
            "telephone_number": "516-626-1340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 CLOCK TOWER LN",
            "city": "OLD WESTBURY",
            "state": "NY",
            "postal_code": "115681003",
            "telephone_number": "516-626-1340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACKLES",
        "first_name": "MICHELLE",
        "middle_name": "RENEE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-26",
        "last_updated": "2012-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "225522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• New York Institute of Technology (Academic Health Care Center)
• Philip Noto
• Marie Terese Oppedisano, PHD
• Lauren Joan Osei, APRN, FNP
• Otolaryngology Facial Plastic Surgery Associates
• Maria M. Plummer, M.D.
• Premier Endoscopy Suites PC
• Mary Pryor, AUD CCC-A
• Moriah Sanam Rastegar
• Rebecca Patricia Raynor, PA

• Ophthalmology Physician in Old Westbury, NY
• Providers in Old Westbury, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2012; 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.