Scott L Derco, O.D.

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

VUT-4532-1 Issued in NY

Practice address

2044 Sunrise Hwy
Bay Shore, NY 11706-6018

Phone

(631) 666-9595

Fax

(631) 206-1968

NPI assigned

Mar 19, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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

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.

• Focus Medical Ny, PLLC

  • Optometrist
  • Brooklyn, NY
  • NPI 1801679238
  Medicare reassignment NPD
• Bayshore Vision Center,Inc.

  • Corneal and Contact Management Optometrist
  • Bay Shore, NY
  • NPI 1598932709
  NPD (past) Authorized official

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209600000000",
    "number": "1699899260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 GLEN SUMMER RD",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117415029",
            "telephone_number": "631-472-2552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2044 SUNRISE HWY",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117066018",
            "telephone_number": "631-666-9595",
            "fax_number": "631-206-1968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERCO",
        "first_name": "SCOTT",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2008-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NY",
            "license": "VUT-4532-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01964218",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandra Demetriou, OTR L CHT
• Kathy Deng, M.D.
• Jasmin Dengeles, LMSW
• Jessica Elizabeth Dennehy
• Denise Dent, LPN
• Diane Mary Derenches, RN
• Mia R Dericco
• Dermatology Group, PC
• Dana Deruvo Hanner
• Basavaraj Veeranna Desai, MD

• Corneal and Contact Management Optometrist in Bay Shore, NY
• Providers in Bay Shore, NY by specialty
• Corneal and Contact Management Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.