Individual provider Active NPI

Donna Joy Mangatt, O.D.

  • Optometrist
  • Fort Myers, FL
National Provider Identifier
1821168741
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
FL4035 Issued in FL
Practice address
4125 Cleveland Ave
Sears Optical Ste 88
Fort Myers, FL 33901-9046
Phone
(239) 693-3937
NPI assigned
Nov 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X FL4035 FL Primary

Addresses

Primary practice location

4125 Cleveland Ave
Sears Optical Ste 88
Fort Myers, FL 33901-9046

Mailing address

2 E Suffolk Ave
Central Islip, NY 11722-2340
Phone (163) 171-5755

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
I20190402001375 NY Practitioner - Optometry 9436219862 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brooke Plaza Optical, Inc.Group PAC ID 3274681523, 2 clinicians

Practice addresses (Care Compare)

3450 Long Beach Rd
Oceanside, NY 11572-5440
Phone (516) 678-1616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
FL4035FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Brooke Plaza Optical, Inc. Optometrist CurrentSince Dec 1, 2024 Accepting new patients
National Vision, Inc. Past Accepting new patients
Gulf Coast Optometry, PA PastSince Jun 1, 2010 Accepting new patients
National Vision, Inc. Past Accepting new patients
Everything Optical for Less, Inc. Optometrist PastSince Mar 18, 2009 Accepting new patients

Locations

3450 Long Beach Rd
Oceanside, NY 11572
Phone (516) 678-1616

Organizations & group practices 5

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1821168741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 E SUFFOLK AVE",
            "city": "CENTRAL ISLIP",
            "state": "NY",
            "postal_code": "117222340",
            "telephone_number": "163-171-5755",
            "fax_number": "163-123-4010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4125 CLEVELAND AVE",
            "address_2": "SEARS OPTICAL STE 88",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019046",
            "telephone_number": "239-693-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGATT",
        "first_name": "DONNA",
        "middle_name": "JOY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "FL4035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.