MCC Optometry of Roosevelt PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MCC OPTOMETRY OF ROOSEVELT PLLC

Practice address

3938 62ND St
Woodside, NY 11377-3632

Phone

(718) 427-4795

NPI assigned

Aug 3, 2017

Organization subpart

No

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

Authorized official

Name

Mary Claire CarandangNPI 1891234654

Title

Owner

Phone

(718) 427-4795

Specialties & licenses 1

Addresses

Other names 1

• Eyespecs Vision Care Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Claire Carandang, OD

  • Optometrist
  • Brooklyn, NY
  • NPI 1891234654
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1501718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1780109447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39-38 62ND STREET",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773632",
            "telephone_number": "718-427-4795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3938 62ND ST",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773632",
            "telephone_number": "718-427-4795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCC OPTOMETRY OF ROOSEVELT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-03",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CARANDANG",
        "authorized_official_first_name": "MARY CLAIRE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-427-4795"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eyespecs Vision Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Benjamin Fateh Mason, MD
• Jill Mastrandrea, MHC
• Zoe Rebecca Mattana, DDS
• Maureen Desepeda Physical Therapy PC
• Stefanie Mayrhofer, RN
• Donna E McCabe
• Ryan Christine McGovern, M.S.ED.
• Edward M McMorris I
• Brian T McNeary, M.D.
• Thomas Meade, LMT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.