Anthony Modesto, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV00395-1 Issued in NY

Practice address

385 Route 25a
Suite 6
Miller Place, NY 11764-2525

Phone

(631) 642-8400

Fax

(631) 642-8403

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dr.Anthony Modesto OD PC

  • Optometrist
  • Miller Place, NY
  • NPI 1750573093
  NPD Authorized official

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851478259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 ROUTE 25A",
            "address_2": "SUITE 6",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117642525",
            "telephone_number": "631-642-8400",
            "fax_number": "631-642-8403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 ROUTE 25A",
            "address_2": "SUITE 6",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117642525",
            "telephone_number": "631-642-8400",
            "fax_number": "631-642-8403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODESTO",
        "first_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV00395-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00654848",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miller Place Neurology and Sleep Specialty PC
• Miller Place Physical Therapy PC
• Miller Place PT, Family Health NP and Chiropractic PLLC
• Miller Place Ufsd
• Miller Places Dental Associates
• Justine Mongeau
• Ilene B Morris
• Christine Michele Mosher, LCSW
• Maureen Lynn Moy, PT
• Lisa Murphy, LMSW

• Optometrist in Miller Place, NY
• Providers in Miller Place, 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 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.