DR. MICHAEL JAMES MCGOVERN (NPI# 1669470530) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669470530 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL JAMES MCGOVERN |
| Credential | O.D. |
| Practice Address |
624 Hawkins Ave Suite #1 Lake Ronkonkoma NY 11779-2324 |
| Mailing Address |
624 Hawkins Ave Suite 1 Lake Ronkonkoma NY 11779-2324 |
| Practice Telephone | 6315885100 |
| Mailing Telephone | 6315885100 |
| Mailing Fax Number | 6315885185 |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2008-05-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | OD2344 | TN | Eye and Vision Services Providers |
| Y | 152W00000X | Optometrist | TUV5891 | NY | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01870373 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801313051 | Michael Joespeh Mcgovern | Specialist/Technologist | 4121 Long Leaf Dr, Melbourne, FL 32940-1462 | 2017-08-28 |
| 1679103014 | Michael Mcgovern | Physician Assistant | 5230 Centre Ave, Pittsburgh, PA 15232-1304 | 2020-01-24 |
| 1659712552 | Michael Mcgovern | Social Worker | 47 Town St, Norwich, CT 06360-2315 | 2013-07-09 |
| 1215270640 | Michael E Mcgovern | Peer Specialist | 304 S Niagara St, Saginaw, MI 48602-1570 | 2013-04-04 |
| 1467674663 | Michael Mcgovern | Dentist | 1368 Union St, Schenectady, NY 12308-3017 | 2007-05-03 |
| 1336365030 | Michael Edward Mcgovern | Chiropractor | 382 Randall Rd, South Elgin, IL 60177-3318 | 2007-04-18 |
| Street Address |
624 HAWKINS AVE SUITE #1 |
| City | LAKE RONKONKOMA |
| State | NY |
| Zip Code | 11779-2324 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578566485 | Richard Soden | Optometrist | 624 Hawkins Ave, Ste 1, Lake Ronkonkoma, NY 11779-2324 | 2005-05-24 |
| 1982210274 | Jillian Saltzman | Speech-Language Pathologist | 624 Hawkins Ave, Lake Ronkonkoma, NY 11779-2375 | 2020-09-22 |
| 1699386292 | Kristen Jeanette Eckert | Speech-Language Pathologist | 624 Hawkins Ave, Lake Ronkonkoma, NY 11779-2375 | 2020-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750929139 | Sebastian Godinez | Student in an Organized Health Care Education/Training Program | 11 First Street, Ronkonkoma, NY 11779 | 2019-12-16 |
| 1487149860 | John Deming | Student in an Organized Health Care Education/Training Program | 142 - 02 20th Avenue, Flushing, NY 11779 | 2018-06-27 |
| 1376060392 | Janine D'annunzio | Specialist | 316 Thirft Street, Ronkonkoma, NY 11779 | 2017-08-30 |
| 1932621935 | Vincent Joseph Lopreto | Counselor | 253 Lake Shore Road, Ronkonkoma, NY 11779 | 2017-07-11 |
| 1598295271 | Dalas Taddeo | Licensed Practical Nurse | 4490 Express Drive S, Ronkonkoma, NY 11779 | 2017-06-15 |
| 1790214112 | Pamela Ferrante | Social Worker | 131 Avenue D, Ronkonkoma, NY 11779 | 2017-06-08 |
| 1255868915 | Bari Home Care LLC | Health Maintenance Organization | 4417 Express Drive North, Ronkonkoma, NY 11779 | 2017-05-12 |
| 1013441328 | Caring Hands Home Care | Nursing Facility/Intermediate Care Facility | 65 Cheryl Drive, Ronkonkoma, NY 11779 | 2017-04-13 |
| 1831552025 | Jacqueline Galdamez | Social Worker | 979 Johnson Avenue, Ronkonkoma, NY 11779 | 2016-04-04 |
| 1891192530 | Alex Mitchell Pollack | Massage Therapist | 34 Richmond Blvd, #3a, Ronkonkoma, NY 11779 | 2014-11-24 |
| Find all providers in zip 11779 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447601729 | Tracy Rossi | Optometrist | 624 Hawkins Ave Ste 1, Lake Ronkonkoma, NY 11779-2375 | 2016-06-28 |
| 1609995844 | Tracy K Brooks | Optometrist | 388 Hawkins Ave Ste 2, Lake Ronkonkoma, NY 11779-4280 | 2007-03-28 |
| 1578566485 | Richard Soden | Optometrist | 624 Hawkins Ave, Ste 1, Lake Ronkonkoma, NY 11779-2324 | 2005-05-24 |
| 1770964926 | Michele Espinosa | Optometrist | 388 Hawkins Ave, Suite 2, Lake Ronkonkoma, NY 11779-4280 | 2015-06-13 |
| 1831219591 | Frank Thomas Adam | Optometrist | 500 Portion Rd, Suite 10, Lake Ronkonkoma, NY 11779-4587 | 2007-03-29 |
| 1780717199 | Pscg Optics Inc | Optometrist | 388 Hawkins Ave, Suite 2, Lake Ronkonkoma, NY 11779-4280 | 2007-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770225 | Quality Eye Care Nyc Optometry PC | Optometrist | 1755 Richmond Rd, Staten Island, NY 10306-2558 | 2020-11-02 |
| 1134727860 | Paras Patel | Optometrist | 891 Route 9 Ste 700, Queensbury, NY 12804-1796 | 2020-10-14 |
| 1962009175 | Designer Optical of Plains Parkway | Optometrist | 2196a White Plains Rd, Bronx, NY 10462-1406 | 2020-10-01 |
| 1962018184 | Anna Dobrokhodova | Optometrist | 2425 29th St Apt 3f, Astoria, NY 11102-1642 | 2020-09-22 |
| 1073129813 | Kajal Kirti Patel | Optometrist | 506 Amsterdam Ave Apt 3b, New York, NY 10024-3951 | 2020-09-17 |
| 1538772157 | Wilzen Anne Lingad O.d., Pllc | Optometrist | 4117 Crescent St, Long Island City, NY 11101-3861 | 2020-08-24 |
| 1760095384 | Mk Vision Center I, Inc | Optometrist | 7010 Austin St Ste 2, Forest Hills, NY 11375-4763 | 2020-08-24 |
| 1699387266 | V. Bolbirer Od P.C. | Optometrist | 1721 Avenue M, Brooklyn, NY 11230-5303 | 2020-08-17 |
| 1235749045 | Jessica V Vaidya | Optometrist | 2480 Grand Concourse, Bronx, NY 10458-5201 | 2020-08-06 |
| 1154930881 | Safeera Zafar Bhutta | Optometrist | 36 Lexington Ave, Malverne, NY 11565-2316 | 2020-07-28 |
| Find all providers with the same taxonomy | ||||
| City | LAKE RONKONKOMA |
| Zip Code | 11779 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.