Individual provider Active NPI

Mario J Fracassa, MD

  • Ophthalmology Physician
  • Plainview, NY
National Provider Identifier
1780681478
Registry record updated Sep 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
102903 Issued in NY
Practice address
732 Old Country Rd
Plainview
Plainview, NY 11803-4929
Phone
(516) 822-3911
Fax
(516) 822-3983
NPI assigned
Jul 7, 2005
Last updated
Sep 9, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 102903 NY Primary

Addresses

Primary practice location

732 Old Country Rd
Plainview
Plainview, NY 11803-4929

Mailing address

825 E Gate Blvd Ste 111
Garden City, NY 11530-2136
Phone (516) 804-5200

Other identifiers 2

IdentifierTypeStateIssuer
00178390MedicaidNY
CB2940OtherNYRAILROAD MEDICARE

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050214000382 NY Practitioner - Ophthalmology 4587616032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
New York Medical College, 1967
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

135 Crossways Park Dr
Suite 101
Woodbury, NY 11797-2005
Phone (516) 822-3911

2000 N Village Ave
Rockville Centre, NY 11570-1078
Phone (516) 766-2519

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
102903NYMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ophthalmic Consultants of Long Island Ophthalmology CurrentSince May 1, 2014 Accepting new patients
Ophthalmic Consultants of Long Island Ophthalmology Past Accepting new patients
Mario Fracassa MDPC Ophthalmology PastSince Oct 3, 1987 Accepting new patients

Locations

825 E Gate Blvd
Ste 111
Garden City, NY 11530
Phone (516) 804-5200

732 Old Country Rd
Plainview, NY 11803
Phone (516) 822-3911

2000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1777

2000 N Village Ave
#13202
Rockville Ctr, NY 11570
Phone (516) 766-2519

865 Merrick Ave
Ste 80N
Westbury, NY 11590
Phone (516) 804-5200

135 Crossways Park Dr
Ste 101
Woodbury, NY 11797
Phone (516) 822-3911

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: mario.fracassa.p1@direct.ocli.nextgenshare.com

Organizations & group practices 3

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1780681478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 E GATE BLVD STE 111",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302136",
            "telephone_number": "516-804-5200",
            "fax_number": "516-240-6540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 OLD COUNTRY RD",
            "address_2": "PLAINVIEW",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118034929",
            "telephone_number": "516-822-3911",
            "fax_number": "516-822-3983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRACASSA",
        "first_name": "MARIO",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "102903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00178390",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CB2940",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainview, NY

Sources for this page

Verify at the official NPI Registry.