Organization Active NPI

Rustagi Eye Associates LLC

  • Optometrist
  • West New York, NJ
National Provider Identifier
1043451271
Registry record updated Mar 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00584500 Issued in NJ
Legal business name
RUSTAGI EYE ASSOCIATES LLC
Practice address
5202 Bergenline Ave
West New York, NJ 07093-5524
Phone
(201) 974-2999
Fax
(201) 974-2999
NPI assigned
Mar 18, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2009

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

Authorized official

Name
Dr. Saras Rustagi, O.D.NPI 1427110311
Title
Owner
Phone
(201) 450-5264

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 27OA00584500 NJ Primary

Addresses

Primary practice location

5202 Bergenline Ave
West New York, NJ 07093-5524

Mailing address

5202 Bergenline Ave
West New York, NJ 07093-5524
Phone (201) 974-2999

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040114000636 NJ Part B Supplier - Clinic/Group Practice 3274434170 Receives reassigned benefits from 2 practitioners
Practice locations: Morristown, NJ; Ridgewood, NJ; Upper Montclair, NJ; West New York, NJ

National Provider Directory

National Provider Directory

Locations

286 State Rt 23
Franklin, NJ 07416
Phone (973) 209-2020

211 Bellevue Ave
Upper Montclair, NJ 07043
Phone (201) 450-5264

Practitioners & affiliated clinicians

Practitioners 3

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": "1237334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237334400000",
    "number": "1043451271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5202 BERGENLINE AVE",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070935524",
            "telephone_number": "201-974-2999",
            "fax_number": "201-974-2999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5202 BERGENLINE AVE",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070935524",
            "telephone_number": "201-974-2999",
            "fax_number": "201-974-2999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSTAGI EYE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-18",
        "last_updated": "2009-03-18",
        "status": "A",
        "authorized_official_last_name": "RUSTAGI",
        "authorized_official_first_name": "SARAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-450-5264",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00584500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West New York, NJ

Sources for this page

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