Organization Active NPI

Garden State Eye Center, P.a.

  • Ophthalmology Physician
  • Lakewood, NJ
National Provider Identifier
1053445197
Registry record updated Nov 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
GARDEN STATE EYE CENTER, P.A.
Practice address
1195 Highway 70
Lakewood, NJ 08701-5946
Phone
(732) 363-2244
Fax
(732) 363-1825
NPI assigned
Mar 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2008

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

Authorized official

Name
Moshe M Rothkopf, MDNPI 1720049588
Title
President Owner
Phone
(732) 363-2244

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
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1195 Highway 70
Lakewood, NJ 08701-5946

Mailing address

1195 Highway 70
Lakewood, NJ 08701-5946
Phone (732) 363-2244

Other identifiers 2

IdentifierTypeStateIssuer
1051964OtherAETNA
3421708MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090107000238 NJ Part B Supplier - Clinic/Group Practice 3072409515 Receives reassigned benefits from 2 practitioners
Practice locations: Lakewood, NJ; Toms River, NJ

National Provider Directory

National Provider Directory

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": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226620800000",
    "number": "1053445197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1195 HIGHWAY 70",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015946",
            "telephone_number": "732-363-2244",
            "fax_number": "732-363-1825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1195 HIGHWAY 70",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015946",
            "telephone_number": "732-363-2244",
            "fax_number": "732-363-1825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN STATE EYE CENTER, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2008-11-14",
        "status": "A",
        "authorized_official_last_name": "ROTHKOPF",
        "authorized_official_first_name": "MOSHE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "732-363-2244",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1051964",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3421708",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2008; 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.