Individual provider Active NPI

Glenn Douglas Scibilia, MD

  • Ophthalmology Physician
  • Bay Shore, NY
National Provider Identifier
1720057060
Registry record updated Oct 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
190316 Issued in NY
Practice address
375 E Main St
Suite 24
Bay Shore, NY 11706
Phone
(631) 665-1330
Fax
(631) 665-1363
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 190316 NY Primary

Addresses

Primary practice location

375 E Main St
Suite 24
Bay Shore, NY 11706

Mailing address

375 E Main St
Suite 24
Bay Shore, NY 11706
Phone (631) 665-1330

Other identifiers 1

IdentifierTypeStateIssuer
01592429MedicaidNY

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040414000270 NY Practitioner - Ophthalmology 3274527999 Reassigns benefits to 1 organization
Practice locations: West Islip, NY; Bay Shore, NY

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sight Medical Doctors PLLCGroup PAC ID 5991935173, 115 clinicians

Practice addresses (Care Compare)

375 E Main St
Suite 24
Bay Shore, NY 11706-8418
Phone (631) 655-1330

Merit-based Incentive Payment System (MIPS)

Final score
91.5 of 100Reported as group
Quality
90
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery185

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sight Medical Doctors PLLC CurrentSince Mar 1, 2015 Accepting new patients
Sight Medical Doctors PLLC Ophthalmology CurrentSince Mar 1, 2015 Accepting new patients

Locations

180 E Main St
Bay Shore, NY 11706
Phone (631) 665-0027

375 E Main St
Ste 24
Bay Shore, NY 11706
Phone (631) 665-1330

601 Suffolk Ave
Ste 1
Brentwood, NY 11717
Phone (631) 273-3335

601 Suffolk Ave
Brentwood, NY 11717
Phone (631) 231-4384

250 Patchogue Yaphank Rd
Ste 1
East Patchogue, NY 11772
Phone (631) 289-0678

125 Kennedy Dr
Ste 400
Hauppauge, NY 11788

1500 Route 112
Bldg 6
Port Jefferson Station, NY 11776
Phone (631) 686-7890

260 E Middle Country Rd
Ste 201
Smithtown, NY 11787
Phone 6312658780150

Networks

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350432000000",
    "number": "1720057060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 E MAIN ST",
            "address_2": "SUITE 24",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "11706",
            "telephone_number": "631-665-1330",
            "fax_number": "631-665-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 E MAIN ST",
            "address_2": "SUITE 24",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "11706",
            "telephone_number": "631-665-1330",
            "fax_number": "631-665-1363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCIBILIA",
        "first_name": "GLENN",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2012-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "190316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01592429",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.