Individual provider Active NPI

Michele Espinosa

  • Optometrist
  • Lake Ronkonkoma, NY
National Provider Identifier
1770964926
Registry record updated Jun 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
008289 Issued in NY
Practice address
388 Hawkins Ave
Suite 2
Lake Ronkonkoma, NY 11779-4280
Phone
(631) 588-7004
NPI assigned
Jun 13, 2015
Last updated
Jun 13, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 008289 NY Primary

Addresses

Primary practice location

388 Hawkins Ave
Suite 2
Lake Ronkonkoma, NY 11779-4280

Mailing address

2 Hamlet Dr
Hauppauge, NY 11788-3338
Phone (631) 796-5051

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
I20160115002476 NY Practitioner - Optometry 4082917513 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

360 Montauk Hwy
West Islip, NY 11795-4403
Phone (631) 422-1112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008289NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Surgical Eye Care Services PC CurrentSince Apr 28, 2021 Accepting new patients
PSCG Optics Inc Optometrist CurrentSince Nov 7, 2015 Accepting new patients
H&R Optical Services Inc. Optometrist CurrentSince Nov 7, 2015 Accepting new patients
200 West Optics, LLC Optometrist PastSince Nov 7, 2015 Accepting new patients

Locations

21 W Merrick Rd
Freeport, NY 11520
Phone (516) 378-2843

21 W Merrick Rd
Unit 2
Freeport, NY 11520
Phone (516) 379-4041

388 Hawkins Ave
Ste 2
Ronkonkoma, NY 11779
Phone (631) 588-7004

360 Montauk Hwy
West Islip, NY 11795
Phone (631) 422-1110

Interoperability endpoints

  • Direct secure messaging: mespinosa@tceco.intellechartdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1434153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434153600000",
    "number": "1770964926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 HAMLET DR",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117883338",
            "telephone_number": "631-796-5051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 HAWKINS AVE",
            "address_2": "SUITE 2",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117794280",
            "telephone_number": "631-588-7004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPINOSA",
        "first_name": "MICHELE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-13",
        "last_updated": "2015-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "008289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Ronkonkoma, NY

Sources for this page

Verify at the official NPI Registry.