Individual provider Active NPI

Marissa Zimmerman, OD

  • Optometrist
  • Garden City, NY
National Provider Identifier
1982045522
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV008026-1 Issued in NY
Practice address
300 Garden City PLZ Ste 404
Garden City, NY 11530-3332
Phone
(516) 224-4888
Fax
(516) 280-7052
NPI assigned
Jul 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV008026-1 NY Primary

Addresses

Primary practice location

300 Garden City PLZ Ste 404
Garden City, NY 11530-3332

Mailing address

300 Garden City PLZ Ste 404
Garden City, NY 11530-3332
Phone (516) 224-4888

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
I20140402000027 NY Practitioner - Optometry 9234360421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

300 Garden City PLZ
Suite 404
Garden City, NY 11530-3332
Phone (516) 224-4888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV008026-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Optometric Office of Cheryl Berger Israeloff, O.D., PLLC Optometrist CurrentSince Nov 1, 2017 Accepting new patients
We'LL See Enterprises, Inc. Optometrist PastSince Jan 9, 2016 Accepting new patients
R & R Optical Vision LLC PastSince Jan 17, 2021 Accepting new patients

Locations

300 Garden City Plz
Ste 404
Garden City, NY 11530
Phone (516) 224-4888

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": "1373500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1982045522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 GARDEN CITY PLZ STE 404",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115303332",
            "telephone_number": "516-224-4888",
            "fax_number": "516-280-7052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 GARDEN CITY PLZ STE 404",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115303332",
            "telephone_number": "516-224-4888",
            "fax_number": "516-280-7052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "MARISSA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-11",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV008026-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

Verify at the official NPI Registry.