Individual provider Active NPI

Jayswinder Kaur, OD

  • Optometrist
  • Irvington, NJ
National Provider Identifier
1013560077
Registry record updated Jul 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00689700 Issued in NJ
Practice address
1068 Clinton Ave
Irvington, NJ 07111-3501
Phone
(973) 399-0909
NPI assigned
Jul 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OA00689700 NJ Primary

Addresses

Primary practice location

1068 Clinton Ave
Irvington, NJ 07111-3501

Mailing address

107 Grant Ave
Carteret, NJ 07008-2746
Phone (732) 589-9612

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20200212002172 NJ Practitioner - Optometry 7315373263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pink Vision Associates LLCGroup PAC ID 6002087343, 4 clinicians

Practice addresses (Care Compare)

1068 Clinton Ave
Irvington, NJ 07111-3501
Phone (973) 399-0909

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OA00689700NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pink Vision Associates LLC Optometrist CurrentSince Dec 31, 2019 Accepting new patients

Locations

1068 Clinton Ave
Irvington, NJ 07111
Phone (973) 399-0909

Organizations & group practices 1

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": "1563408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1013560077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 GRANT AVE",
            "city": "CARTERET",
            "state": "NJ",
            "postal_code": "070082746",
            "telephone_number": "732-589-9612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1068 CLINTON AVE",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071113501",
            "telephone_number": "973-399-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUR",
        "first_name": "JAYSWINDER",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-18",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00689700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvington, NJ

Sources for this page

Verify at the official NPI Registry.