Individual provider Active NPI

Joseph L Bacotti, MD

  • Ophthalmology Physician
  • Mineola, NY
National Provider Identifier
1962403519
Registry record updated Sep 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
139827 Issued in NY
Practice address
330 Old Country Rd
Number 100
Mineola, NY 11501
Phone
(516) 739-6600
Fax
(516) 739-6620
NPI assigned
Aug 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 139827 NY Primary

Addresses

Primary practice location

330 Old Country Rd
Number 100
Mineola, NY 11501

Mailing address

825 E Gate Blvd Ste 111
Garden City, NY 11530-2124
Phone (516) 804-5200

Other identifiers 1

IdentifierTypeStateIssuer
00436246MedicaidNY

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040211000589 NY Practitioner - Ophthalmology 0547154403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ophthalmic Consultants of Long IslandGroup PAC ID 8022909076, 107 clinicians

Practice addresses (Care Compare)

330 Old Country Rd
Suite 100
Mineola, NY 11501-4143
Phone (516) 739-6600

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
139827NYMDOphthalmology Physician

Practice roles (3 of 7)

OrganizationSpecialtyStatusNew patients
Ophthalmic Consultants of Long Island Ophthalmology CurrentSince Sep 19, 2011 Accepting new patients
Joseph Bacotti MD PC PastSince Aug 14, 2003 Accepting new patients
Ophthalmic Consultants of Long Island Ophthalmology Past Accepting new patients

Locations

4 Technology Dr
Ste 150
East Setauket, NY 11733
Phone (631) 941-1400

825 E Gate Blvd
Ste 111
Garden City, NY 11530
Phone (516) 804-5200

189 Forest Ave
Ste 2C
Glen Cove, NY 11542
Phone (516) 674-3000

649 Broadway
Massapequa, NY 11758
Phone (516) 798-1411

2000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1777

2000 N Village Ave
#13202
Rockville Ctr, NY 11570
Phone (516) 766-2519

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: joseph.bacotti.p1@direct.ocli.nextgenshare.com

Organizations & group practices 4

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": "1123113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536019200000",
    "number": "1962403519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 E GATE BLVD STE 111",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302124",
            "telephone_number": "516-804-5200",
            "fax_number": "516-240-6540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 OLD COUNTRY RD",
            "address_2": "NUMBER 100",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "11501",
            "telephone_number": "516-739-6600",
            "fax_number": "516-739-6620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACOTTI",
        "first_name": "JOSEPH",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-04",
        "last_updated": "2018-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "139827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00436246",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.