Loganne Tatjana Mikkelsen, OD

Primary specialty

Vision Therapy OptometristTaxonomy code 152WV0400X

License

011065 Issued in NY

Practice address

33 W 42ND St
New York, NY 10036-8005

Phone

(212) 938-4000

NPI assigned

Sep 24, 2024

Last updated

Sep 24, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: loganne.mikkelsen.p1@direct.opt.nextgenshare.com

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.

• State of New York Comptrollers Office

  dba Suny College of Optometry/University Eye Center

  • Optometrist
  • New York, NY
  • NPI 1407829856

  Vision Therapy

  Medicare reassignment NPD
• State of New York Comptrollers Office

  • Developmental Disabilities Clinic/Center
  • Staten Island, NY
  • NPI 1750469912
  NPD

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

{
    "created_epoch": "1727136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1942027644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 W 42ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100368005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 W 42ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100368005",
            "telephone_number": "212-938-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKKELSEN",
        "first_name": "LOGANNE",
        "middle_name": "TATJANA",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-24",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "NY",
            "license": "011065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniela Mikhaylov, MD
• Margarita Mikhaylova, D.O
• Mark Mikhly, M.D.
• Alessandra Mikic, LCSW
• Sophia Mikityanskiy, D.O.
• Eeva Johanna Mikkola, M.D.
• Evgeny Mikler, PA-C
• Benjamin Alexander Miko, MD
• Irina Mikolaenko, MD
• Mia Paige Mikowicz

• Vision Therapy Optometrist in New York, NY
• Providers in New York, NY by specialty
• Vision Therapy Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.