Optical Shop Of Deer Park Inc is a medicare enrolled "Eyewear Supplier" provider in Deer Park, New York. Their current practice location is
415 Commack Rd Ste 2b, Deer Park, New York. You can reach out to their office (for appointments etc.) via phone at
(631) 392-0711.
Optical Shop Of Deer Park Inc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Optical Shop Of Deer Park Inc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1386101632.
Healthcare Provider's Profile
| Full Name | Optical Shop Of Deer Park Inc |
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| Type | Facility |
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| Speciality | Eyewear Supplier |
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| Location | 415 Commack Rd Ste 2b, Deer Park, New York |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1386101632
- Provider Enumeration Date: 02/22/2019
- Last Update Date: 07/02/2019
Medicare PECOS Information:
- PECOS PAC ID: 4183951981
- Enrollment ID: O20190815002508
Medical Identifiers
Medical identifiers for Optical Shop Of Deer Park Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1386101632 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Optical Shop Of Deer Park Inc acts as a billing entity for following providers:
| Provider Name | Edward R Deneve |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1114074945
PECOS PAC ID: 0446359012
Enrollment ID: I20070621000626 |
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| Provider Name | John Nguyen |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1598140931
PECOS PAC ID: 7618283839
Enrollment ID: I20150903000037 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Optical Shop Of Deer Park Inc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Optical Shop Of Deer Park Inc
415 Commack Rd Ste 2b,
Deer Park, NY 11729-4508
Ph: (631) 392-0711 | Optical Shop Of Deer Park Inc
415 Commack Rd Ste 2b,
Deer Park, NY 11729-4508
Ph: (631) 392-0711 |
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