Dr. Theresa Loscalzo Bacaris, OD
Optometrist in Mastic, NY. Individual provider (NPI-1).
NPI number1720162431
StatusActive
Last updated in NPPESApr 1, 2016
Details
- NPI
- 1720162431
- Entity type
- Individual (NPI-1)
- Name
- Dr. Theresa Loscalzo Bacaris
- Credential
- OD
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 25, 2006
- Last updated
- Apr 1, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - OPTOMETRY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility No · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | VUT004799-1 | NY | Yes |
Practice location
1360 Montauk HwySte 2e
Mastic, NY 11950-2929
Phone 631-281-2474 · Fax 631-281-2476
Mailing address
1360 Montauk HwySte 2e
Mastic, NY 11950-2929
Phone 631-281-2474 · Fax 631-281-2476
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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