Elena Vitenzon, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA00592900 Issued in NJ

Practice address

216 Franklin Ave
Nutley, NJ 07110-2709

Phone

(973) 542-1105

Fax

(973) 542-1103

NPI assigned

Sep 25, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Nutley Vision LLC

  • Optometrist
  • Nutley, NJ
  • NPI 1497304984
  Medicare reassignment Authorized official
• Nutley Vision

  • Eyewear Supplier
  • Nutley, NJ
  • NPI 1588190656
  NPD (past) Authorized official

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043311962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 JEFFERSON AVE",
            "city": "TENAFLY",
            "state": "NJ",
            "postal_code": "076701931",
            "telephone_number": "201-266-4208",
            "fax_number": "973-542-1103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 FRANKLIN AVE",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071102709",
            "telephone_number": "973-542-1105",
            "fax_number": "973-542-1103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITENZON",
        "first_name": "ELENA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00592900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3737782",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eliezer Willie Viera Sr., LMT
• Hope Chona Tan Villanueva, P.T.
• Rozann Vinci
• Caterina A Viscomi, LPC, LICENSED COACH
• Gary B Vitaletti
• Angela Vivar
• Yeltsie Volcy
• Anna A Volkova, L.AC., PTA
• John L Volpe Jr., O.D.
• Vreeland Associates, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.