Organization Active NPI

Optical Group LTD

  • Optician
  • Newark, NJ
National Provider Identifier
1043340862
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
OPTICAL GROUP LTD
Practice address
786 Broad St
Newark, NJ 07102-3728
Phone
(973) 642-4949
Fax
(973) 621-1830
NPI assigned
Mar 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Peter Brown
Title
Owner
Phone
(212) 594-0751

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193200000X MULTI-SPECIALTY GROUP 156FX1800X Primary

Addresses

Primary practice location

786 Broad St
Newark, NJ 07102-3728

Mailing address

786 Broad St
Newark, NJ 07102-3728
Phone (973) 642-4949

Other identifiers 1

IdentifierTypeStateIssuer
6368000MedicaidNJ

National Provider Directory

National Provider Directory

Locations

786 Broad St
Newark, NJ 07102
Phone (973) 642-4949

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043340862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "786 BROAD ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071023728",
            "telephone_number": "973-642-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "786 BROAD ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071023728",
            "telephone_number": "973-642-4949",
            "fax_number": "973-621-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTICAL GROUP LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-594-0751",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6368000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.