NPIMap

Organization Active NPI

Eyecare Specialties Support of NJ PC

  • Optometrist
  • Blackwood, NJ
National Provider Identifier
1003601287
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYECARE SPECIALTIES SUPPORT OF NJ PC
Practice address
901 Route 168 Ste 409-410
Blackwood, NJ 08012-3210
Phone
(618) 462-9818
Fax
(314) 741-4947
NPI assigned
Apr 10, 2025
Last updated
Oct 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Authorized official

Name
Melissa Allison
Title
Sr. Director MVC
Phone
(618) 604-5208

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

901 Route 168 Ste 409-410
Blackwood, NJ 08012-3210

Mailing address

111 E 4TH St Ste 440
Alton, IL 62002-6206
Phone (618) 462-9818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250630001019 NJ Part B Supplier - Clinic/Group Practice 6800309287 Receives reassigned benefits from 26 practitioners
Practice locations: Aberdeen, NJ; Wyckoff, NJ; Turnersville, NJ; Somerset, NJ; Raritan, NJ; Piscataway, NJ; Manalapan, NJ; Jackson, NJ…

National Provider Directory

National Provider Directory

Locations

302 Union St
Ste 2
Hackensack, NJ 07601
Phone (201) 646-9090

84 E Broad St
Ste 2
Hopewell, NJ 08525
Phone (609) 466-0055

1071 State Route 34
Matawan, NJ 07747
Phone (732) 837-0988

1100 Centennial Ave
Ste 204
Piscataway, NJ 08854
Phone (732) 313-2570

575 Route 28
Ste 106
Raritan, NJ 08869
Phone (908) 725-0144

373 Clinton Ave
Wyckoff, NJ 07481
Phone (201) 891-2772

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1744243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760400000000",
    "number": "1003601287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 4TH ST STE 440",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026206",
            "telephone_number": "618-462-9818",
            "fax_number": "314-741-4947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 ROUTE 168 STE 409-410",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "080123210",
            "telephone_number": "618-462-9818",
            "fax_number": "314-741-4947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE SPECIALTIES SUPPORT OF NJ PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-10",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A",
        "authorized_official_last_name": "ALLISON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "SR. DIRECTOR MVC",
        "authorized_official_telephone_number": "618-604-5208"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blackwood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.