Individual provider Active NPI

Michelle Henesch, OD

  • Vision Therapy Optometrist
  • Monsey, NY
National Provider Identifier
1902636301
Registry record updated Aug 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vision Therapy OptometristTaxonomy code 152WV0400X
License
011134 Issued in NY
Practice address
40 Main St
Monsey, NY 10952-3009
Phone
(845) 385-9500
NPI assigned
Aug 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 011134 NY
Optometrist 152W00000X 27OA00731200 NJ
Pediatric Optometrist 152WP0200X 011134 NY
Vision Therapy Optometrist 152WV0400X 27OA00731200 NJ
Vision Therapy Optometrist 152WV0400X 011134 NY Primary

Addresses

Primary practice location

40 Main St
Monsey, NY 10952-3009

Mailing address

14 Kingsland CT
Fair Lawn, NJ 07410-2747
Phone (347) 587-9672

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
I20250827002010 NY Practitioner - Optometry 9830690403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

16 Sumner PL
Brooklyn, NY 11206-4110
Phone 71895188002102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OA00731200NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ahava Medical and Rehabilitation Center, LLC CurrentSince Jun 21, 2025 Accepting new patients
Visual Performance and Learning Center PC Vision Therapy PastSince Aug 1, 2024 Accepting new patients
Family Eyecare Associates, PC Optometrist PastSince Aug 1, 2024 Accepting new patients

Locations

16 Sumner Pl
Brooklyn, NY 11206
Phone (718) 336-9500

2555 Nostrand Ave
Brooklyn, NY 11210
Phone 7189518800108

25 Carrier St
Liberty, NY 12754
Phone (718) 755-0332

40 Main St
Monsey, NY 10952
Phone (845) 352-6281

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1722470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755993600000",
    "number": "1902636301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 KINGSLAND CT",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102747",
            "telephone_number": "347-587-9672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 MAIN ST",
            "city": "MONSEY",
            "state": "NY",
            "postal_code": "109523009",
            "telephone_number": "845-385-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENESCH",
        "first_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-01",
        "last_updated": "2025-08-24",
        "certification_date": "2025-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "011134",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00731200",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "NY",
            "license": "011134",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "NJ",
            "license": "27OA00731200",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "NY",
            "license": "011134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monsey, NY

Sources for this page

Verify at the official NPI Registry.