Individual provider Active NPI

Gina Minucci, O.D.

  • Corneal and Contact Management Optometrist
  • Stony Brook, NY
National Provider Identifier
1760481311
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
VUT005345 Issued in NY
Practice address
125 Main St
Stony Brook, NY 11790-1911
Phone
(631) 751-2801
Fax
(631) 751-2832
NPI assigned
Jul 16, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X VUT005345 NY Primary

Addresses

Primary practice location

125 Main St
Stony Brook, NY 11790-1911

Mailing address

125 Main St
Stony Brook, NY 11790-1911
Phone (631) 751-2801

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
I20080715000084 NY Practitioner - Optometry 4486615309 Practice locations: Sayville, NY

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15 Greeley Ave
FRNT
Sayville, NY 11782-2605
Phone (631) 589-1850

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
VUT005345NYMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Opticians Inc PastSince Sep 23, 2021 Accepting new patients
Sayville Family Eye Care PastSince May 14, 2007 Accepting new patients
Echo Ophthalmic Dispensing, PC Past Accepting new patients
Rory Bowman OD PC PastSince Oct 27, 2010 Accepting new patients

Organizations & group practices 4

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": "1121472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207612800000",
    "number": "1760481311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 MAIN ST",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117901911",
            "telephone_number": "631-751-2801",
            "fax_number": "631-751-2832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 MAIN ST",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117901911",
            "telephone_number": "631-751-2801",
            "fax_number": "631-751-2832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINUCCI",
        "first_name": "GINA",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-16",
        "last_updated": "2008-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NY",
            "license": "VUT005345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.