Mariateresa Ceravolo, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV006894 Issued in NY

Practice address

325 West St
Canandaigua, NY 14424-1723

Phone

(585) 394-2020

Fax

(585) 394-9261

NPI assigned

Oct 17, 2005

Last updated

Sep 5, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mariateresa Ceravolo Former name

Electronic endpoints 3

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

Pennsylvania College of Optometry, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Western New York Medical Practice PCGroup PAC ID 3870767791, 528 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mariaceravolood@theeyecarecenter.medentdirect.com
• Direct secure messaging: mceravolo432397@direct.rochesterregional.org

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.

• Western New York Medical Practice P.C.

  • Family Medicine Physician
  • Rochester, NY
  • NPI 1063790608
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1760471338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 WEST ST",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241787",
            "telephone_number": "585-394-2020",
            "fax_number": "585-394-9261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 WEST ST",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241723",
            "telephone_number": "585-394-2020",
            "fax_number": "585-394-9261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "784 Pre Emption Rd",
            "address_purpose": "LOCATION",
            "city": "Geneva",
            "state": "NY",
            "postal_code": "144562092",
            "country_code": "US",
            "telephone_number": "585-394-2020",
            "fax_number": "585-394-9261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CERAVOLO",
        "first_name": "MARIATERESA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-17",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02708047",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mariaceravolood@theeyecarecenter.medentdirect.com",
            "affiliation": "N",
            "endpointDescription": "EMR e-mail address for secure sharing of patient information",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "784 Pre Emption Rd",
            "city": "Geneva",
            "state": "NY",
            "country_code": "US",
            "postal_code": "144562092",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mariaceravolood@theeyecarecenter.medentdirect.com",
            "affiliation": "N",
            "endpointDescription": "EMR e-mail address for secure sharing of patient information",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "325 West St",
            "city": "Canandaigua",
            "state": "NY",
            "country_code": "US",
            "postal_code": "144241723",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mariaceravolood@theeyecarecenter.medentdirect.com",
            "affiliation": "N",
            "endpointDescription": "EMR e-mail address for secure sharing of patient information",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1210 Driving Park Ave",
            "city": "Newark",
            "state": "NY",
            "country_code": "US",
            "postal_code": "145131057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARIATERESA",
            "last_name": "CERAVOLO",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Optometrist in Canandaigua, NY
• Providers in Canandaigua, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; 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.