Individual provider Active NPI

Harriette Canellos, O.D.

  • Optometrist
  • New York, NY
National Provider Identifier
1831155407
Registry record updated Dec 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
VUT005412 Issued in NY
Practice address
33 West 42ND Street
New York, NY 10036-8005
Phone
(212) 938-4001
NPI assigned
Apr 24, 2006
Last updated
Dec 16, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X VUT005412 NY Primary

Addresses

Primary practice location

33 West 42ND Street
New York, NY 10036-8005

Mailing address

33 West 42ND Street
New York, NY 10036-8005
Phone (212) 938-4001

Other identifiers 1

IdentifierTypeStateIssuer
00244528MedicaidNY

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
I20040525001273 NY Practitioner - Optometry 6406837780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1992
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

33 W 42ND St
New York, NY 10036-8005
Phone (212) 938-4001

Merit-based Incentive Payment System (MIPS)

Final score
86.46 of 100Reported as group
Quality
73.89
Promoting interoperability
89
Improvement activities
40
Cost
75.72

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
VUT005412NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
State of New York Comptrollers Office Optometrist CurrentSince Jan 1, 1992 Accepting new patients
State of New York Comptrollers Office CurrentSince Jan 1, 1992 Accepting new patients

Locations

33 W 42nd St
New York, NY 10036
Phone (212) 780-4930

33 W 42nd St
Fl 10
New York, NY 10036
Phone (212) 780-4930

University Eye Ctr
New York, NY 10087

Interoperability endpoints

  • Direct secure messaging: harriette.canellos.p1@direct.opt.nextgenshare.com

Organizations & group practices 2

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": "1145836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292457600000",
    "number": "1831155407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 WEST 42ND STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100368005",
            "telephone_number": "212-938-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 WEST 42ND STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100368005",
            "telephone_number": "212-938-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANELLOS",
        "first_name": "HARRIETTE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-24",
        "last_updated": "2010-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "VUT005412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00244528",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.