NPIMap

Individual provider Active NPI

Michael Izzo, MD

  • Ophthalmology Physician
  • Wyomissing, PA
National Provider Identifier
1770077612
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD476619 Issued in PA
Practice address
1802 Papermill Rd
Wyomissing, PA 19610-1100
Phone
(610) 372-0712
Fax
(610) 376-6968
NPI assigned
Jun 14, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Glaucoma Specialist (Ophthalmology) Physician 207WX0009X MD476619 PA
Ophthalmology Physician 207W00000X MD476619 PA Primary

Addresses

Primary practice location

1802 Papermill Rd
Wyomissing, PA 19610-1100

Mailing address

1802 Papermill Rd
Wyomissing, PA 19610-1100
Phone (610) 372-0712

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220609001738 PA Practitioner - Ophthalmology 4082961479 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Temple University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Berks Eye Physicians and Surgeons LTDGroup PAC ID 6406845494, 8 clinicians

Practice addresses (Care Compare)

1802 Papermill Rd
Wyomissing, PA 19610-1100
Phone (610) 372-0712

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery323

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD476619PAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ophthalmic Partners PC Ophthalmology CurrentSince Jul 1, 2022 Accepting new patients
Wills Eye Ophthalmology Clinic, Inc Ophthalmology CurrentSince Jul 1, 2022 Accepting new patients
Berks Eye Physicians & Surgeons, LTD Current Accepting new patients
Berks Eye Physicians & Surgeons LTD Ophthalmology CurrentSince Aug 23, 2023 Accepting new patients

Locations

840 Walnut St
Ste 1230
Philadelphia, PA 19107
Phone (215) 440-3160

840 Walnut St
Ste 1110
Philadelphia, PA 19107
Phone (215) 440-3160

840 Walnut St
Ste 1210
Philadelphia, PA 19107
Phone (215) 928-3240

1802 Papermill Rd
Wyomissing, PA 19610
Phone (610) 372-0712

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1770077612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 PAPERMILL RD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101100",
            "telephone_number": "610-372-0712",
            "fax_number": "610-376-6968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 PAPERMILL RD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101100",
            "telephone_number": "610-372-0712",
            "fax_number": "610-376-6968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZZO",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-14",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0009X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "PA",
            "license": "MD476619",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD476619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.