Michael Raymond Iannuccilli, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODTA00323 Issued in RI

Practice address

553 Kingstown Rd
Optometric Providers of Rhode Island, Inc
Wakefield, RI 02879-3600

Phone

(401) 782-2100

Fax

(401) 848-7402

NPI assigned

May 13, 2006

Last updated

Sep 4, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Optometric Providers of Rhode Island, Inc

  • Optometrist
  • Rumford, RI
  • NPI 1053505263
  NPD (past) Authorized official
• Optometric Providers of Rhode Island, Inc

  • Optometrist
  • Narragansett, RI
  • NPI 1184818007
  NPD (past) Authorized official
• Optometric Providers of Rhode Island, Inc

  • Optometrist
  • Cranston, RI
  • NPI 1528252731
  NPD (past) Authorized official
• Optometric Providers of Rhode Island, Inc

  • Optometrist
  • N Providence, RI
  • NPI 1598959710
  NPD (past) Authorized official
• Optometric Providers of Rhode Island, Inc

  • Optometrist
  • Middletown, RI
  • NPI 1770777997
  NPD (past) Authorized official
• Optometric Providers of Rhode Island, Inc

  • Optometrist
  • Syracuse, NY
  • NPI 1295929404
  Authorized official Same address or phone

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188864000000",
    "number": "1972554053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 ERIE BLVD EAST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13224",
            "telephone_number": "315-445-7465",
            "fax_number": "315-445-7675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "553 KINGSTOWN RD",
            "address_2": "OPTOMETRIC PROVIDERS OF RHODE ISLAND, INC",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028793600",
            "telephone_number": "401-782-2100",
            "fax_number": "401-848-7402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IANNUCCILLI",
        "first_name": "MICHAEL",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2007-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "RI",
            "license": "ODTA00323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Humayun Gazder
• Bailey Hunter, MT-BC
• Joseph Hunyady-Manes, NP
• Joseph G Hyde, LMHC
• Jill Susan Iacono, APRN FNP-C
• Savannah Iasimone
• Innovative Works (SafeCirc)
• Elizabeth Bogardus Ison, LICSW SOCIAL WORKER
• Sherry Jackson, LICSW
• Susan Charlotte Jacobsen, LMHC

• Optometrist in Wakefield, RI
• Providers in Wakefield, RI by specialty
• Optometrist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.