Vision Source of Mt Olive LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA00511800 Issued in NJ

Legal business name

VISION SOURCE OF MT OLIVE LLC

Practice address

135 Route 46 East
Unit E
Budd Lake, NJ 07828

Phone

(862) 258-3200

NPI assigned

Nov 8, 2012

Last updated

Nov 15, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael J Siegel, ODNPI 1427035005

Title

President

Phone

(862) 258-3200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: drsiegel@visionsourcemtolive.eyefinity-direct.com

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael J. Siegel, O.D.

  • Optometrist
  • Budd Lake, NJ
  • NPI 1427035005
  Medicare reassignment Care Compare group NPD Authorized official
• Marc Peter Otto, O.D.

  • Optometrist
  • Lone Tree, CO
  • NPI 1720413552

  NJ

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1352332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352937600000",
    "number": "1063766202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 ROUTE 46 EAST",
            "address_2": "UNIT E",
            "city": "BUDD LAKE",
            "state": "NJ",
            "postal_code": "07828",
            "telephone_number": "862-258-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 ROUTE 46 EAST",
            "address_2": "UNIT E",
            "city": "BUDD LAKE",
            "state": "NJ",
            "postal_code": "07828",
            "telephone_number": "862-258-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION SOURCE OF MT OLIVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-08",
        "last_updated": "2012-11-15",
        "status": "A",
        "authorized_official_last_name": "SIEGEL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "862-258-3200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00511800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Litza Vallejo
• John V. Vecchione, D.D.S
• Vedikh Dynamic Rehab LLC
• Pauline B. Verona
• Donald M Vicaro, PHARMD, RPH
• Dominick Volpe
• Mojtaba Wali, DDS
• Katelyn P Weger, D.M.D
• Chase Whitlow
• Amira Wilkins

• Optometrist in Budd Lake, NJ
• Providers in Budd Lake, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.