Individual provider Active NPI

Anthony Marinelli, OD

  • Optometrist
  • Patchogue, NY
National Provider Identifier
1972526085
Registry record updated Oct 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
VUT005560 Issued in NY
Practice address
331 East Main St
Patchogue, NY 11772
Phone
(631) 758-5300
Fax
(631) 758-5301
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X VUT005560 NY Primary

Addresses

Primary practice location

331 East Main St
Patchogue, NY 11772

Mailing address

279 E 3Rd St
New York, NY 10009-7813
Phone (212) 477-8500

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
I20121115000011 NY Practitioner - Optometry 9133370455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sajid Malik, MD PCGroup PAC ID 6103955265, 9 clinicians

Practice addresses (Care Compare)

20504 Hillside Ave
Hollis, NY 11423-2218
Phone (718) 464-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
VUT005560NYMDOptometrist
005560NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Sajid Malik MD PC Optometrist CurrentSince Jul 22, 2022 Accepting new patients
Woodbury Optical Studio, Inc. Past Accepting new patients
Long Island Behavioral Medicine PC Past Accepting new patients
Sajid Malik MD PC Optometrist Past Accepting new patients
Bobs Optical Inc. Past Accepting new patients

Locations

185 Woodbury Rd
Hicksville, NY 11801
Phone (516) 681-3937

9014 Elmhurst Ave
Jackson Hts, NY 11372
Phone (718) 651-2200

20504 Hillside Ave
Jamaica, NY 11423
Phone (718) 464-2020

Organizations & group practices 5

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350000000000",
    "number": "1972526085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 E 3RD ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100097813",
            "telephone_number": "212-477-8500",
            "fax_number": "212-473-4970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 EAST MAIN ST",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "11772",
            "telephone_number": "631-758-5300",
            "fax_number": "631-758-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINELLI",
        "first_name": "ANTHONY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2012-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "VUT005560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Patchogue, NY

Sources for this page

Verify at the official NPI Registry.