Individual provider Active NPI

Jonathan Wasserstein, O.D.

  • Optometrist
  • Livingston, NJ
National Provider Identifier
1053310235
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00608600 Issued in NJ
Practice address
184 S Livingston Ave
Livingston, NJ 07039-3014
Phone
(973) 758-1151
Fax
(973) 758-1152
NPI assigned
Jul 19, 2005
Last updated
Mar 4, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X V005967 NY
Optometrist 152W00000X 1727 NC
Optometrist 152W00000X 3861 FL
Optometrist 152W00000X 27OA00608600 NJ Primary

Addresses

Primary practice location

184 S Livingston Ave
Livingston, NJ 07039-3014

Mailing address

184 S Livingston Ave
Livingston, NJ 07039-3014
Phone (973) 758-1151

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110613000423 NJ Practitioner - Optometry 6204840234 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

184 S Livingston Ave
Suite 8
Livingston, NJ 07039-3013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3861FLMDOptometrist
27OA00608600NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Livingston Family Eyecare Inc. Optometrist CurrentSince Apr 5, 2011 Accepting new patients
Pearle Vision Inc Past Accepting new patients

Locations

184 S Livingston Ave
Livingston, NJ 07039
Phone (973) 758-1151

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1053310235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 S LIVINGSTON AVE",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070393014",
            "telephone_number": "973-758-1151",
            "fax_number": "973-758-1152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 S LIVINGSTON AVE",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070393014",
            "telephone_number": "973-758-1151",
            "fax_number": "973-758-1152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSERSTEIN",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "V005967",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1727",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "3861",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00608600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

Verify at the official NPI Registry.