Organization Active NPI

Truway Vision Care PA

  • Optometrist
  • Orange, NJ
National Provider Identifier
1043387178
Registry record updated May 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00549800 Issued in NJ
Legal business name
TRUWAY VISION CARE PA
Practice address
311 Main St
Orange, NJ 07050-3607
Phone
(973) 673-5773
Fax
(973) 673-5794
NPI assigned
Nov 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2009

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

Authorized official

Name
Dr. Stellamaria Ngozi Korieocha, ODNPI 1154468973
Title
Optometrist
Phone
(973) 673-5773

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 27OA00549800 NJ Primary

Addresses

Primary practice location

311 Main St
Orange, NJ 07050-3607

Mailing address

311 Main St
Orange, NJ 07050-3607
Phone (973) 673-5773

Other identifiers 1

IdentifierTypeStateIssuer
7455801MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050113000694 NJ Part B Supplier - Clinic/Group Practice 3971552209 Receives reassigned benefits from 1 practitioner
Practice locations: Orange, NJ

National Provider Directory

National Provider Directory

Locations

311 Main St
Orange, NJ 07050
Phone (973) 673-5773

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": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242604800000",
    "number": "1043387178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 MAIN ST",
            "city": "ORANGE",
            "state": "NJ",
            "postal_code": "070503607",
            "telephone_number": "973-673-5773",
            "fax_number": "973-673-5794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 MAIN ST",
            "city": "ORANGE",
            "state": "NJ",
            "postal_code": "070503607",
            "telephone_number": "973-673-5773",
            "fax_number": "973-673-5794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUWAY VISION CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2009-05-18",
        "status": "A",
        "authorized_official_last_name": "KORIEOCHA",
        "authorized_official_first_name": "STELLAMARIA",
        "authorized_official_middle_name": "NGOZI",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "973-673-5773",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00549800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7455801",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2009; 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.