Eyedeal Eyecare PC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

EYEDEAL EYECARE PC

Practice address

328B Sparta Ave
Sparta, NJ 07871-1167

Phone

(973) 604-2020

NPI assigned

Jan 7, 2022

Organization subpart

No

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

Authorized official

Name

Tanya Mikitchenko, ODNPI 1902219033

Title

Optometrist/ Owner

Phone

(973) 604-2020

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tanya Mikitchenko, O.D.

  • Optometrist
  • Sparta, NJ
  • NPI 1902219033
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1641513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641513600000",
    "number": "1023779386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328B SPARTA AVE",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078711167",
            "telephone_number": "973-604-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328B SPARTA AVE",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078711167",
            "telephone_number": "973-604-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYEDEAL EYECARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-07",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A",
        "authorized_official_last_name": "MIKITCHENKO",
        "authorized_official_first_name": "TANYA",
        "authorized_official_title_or_position": "OPTOMETRIST/ OWNER",
        "authorized_official_telephone_number": "973-604-2020",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Quigley, DMD, LLC
• Jenna Eoga, PT, DPT
• Ebony Erickson
• Neysa Etienne, LMFT
• Andrew Michael Evans, DPT
• Diane L. Fabery, O.D.
• Carmen Falduto, MA
• Family Intervention Services Inc
• Alexis Faria
• Patrick Farrell

• Optometrist in Sparta, NJ
• Providers in Sparta, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; 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.