NPIMap

Organization Active NPI

Modern Eye Care of NJ

  • Optometrist
  • Holmdel, NJ
National Provider Identifier
1063168227
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MODERN EYE CARE OF NJ
Practice address
2128 State Route 35
Holmdel, NJ 07733-2822
Phone
(732) 858-1646
NPI assigned
Feb 25, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Authorized official

Name
Dr. Jackline Zaky Shawki, ODNPI 1841613569
Title
Optometrist/Owner
Phone
(732) 858-1646

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: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

2128 State Route 35
Holmdel, NJ 07733-2822

Mailing address

2128 State Route 35
Holmdel, NJ 07733-2822
Phone (732) 858-1646

Other names 1

  • Modern Eye Care of NJ Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Info@shawkilaw.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220408000866 NJ Part B Supplier - Clinic/Group Practice 7719373257 Receives reassigned benefits from 3 practitioners
Practice locations: Holmdel, NJ

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: info@shawkilaw.com

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": "1645747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695859200000",
    "number": "1063168227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2128 STATE ROUTE 35",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077332822",
            "telephone_number": "732-858-1646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2128 STATE ROUTE 35",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077332822",
            "telephone_number": "732-858-1646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN EYE CARE OF NJ",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-25",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A",
        "authorized_official_last_name": "SHAWKI",
        "authorized_official_first_name": "JACKLINE",
        "authorized_official_middle_name": "ZAKY",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "732-858-1646",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Info@shawkilaw.com",
            "affiliation": "N",
            "address_1": "2128 State Route 35",
            "city": "Holmdel",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "077332822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Modern Eye Care of NJ",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Modern Eye Care of NJ",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Holmdel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; 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.