Organization Active NPI

University Children's Eye Center, PC

  • Corneal and Contact Management Optometrist
  • East Brunswick, NJ
National Provider Identifier
1073612149
Registry record updated Nov 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
Legal business name
UNIVERSITY CHILDREN'S EYE CENTER, PC
Practice address
4 Cornwall CT
East Brunswick, NJ 08816-3331
Phone
(732) 613-9191
Fax
(732) 613-1139
NPI assigned
Sep 22, 2006
Last updated
Nov 29, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2010

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

Authorized official

Name
Dr. J Mark Engel
Title
President
Phone
(732) 613-9191

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU
Corneal and Contact Management Optometrist 152WC0802X NU Primary
Pediatric Optometrist 152WP0200X NU
Vision Therapy Optometrist 152WV0400X NU
Specialist 174400000X NU

Addresses

Primary practice location

4 Cornwall CT
East Brunswick, NJ 08816-3331

Mailing address

4 Cornwall CT
East Brunswick, NJ 08816-3331
Phone (732) 613-9191

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101206000765 NJ Part B Supplier - Clinic/Group Practice 5991992786 Receives reassigned benefits from 2 practitioners
Practice locations: East Brunswick, NJ

National Provider Directory

National Provider Directory

Locations

4 Cornwall Ct
East Brunswick, NJ 08816
Phone (732) 613-9191

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290988800000",
    "number": "1073612149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CORNWALL CT",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088163331",
            "telephone_number": "732-613-9191",
            "fax_number": "732-613-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CORNWALL CT",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088163331",
            "telephone_number": "732-613-9191",
            "fax_number": "732-613-1139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY CHILDREN'S EYE CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2010-11-29",
        "status": "A",
        "authorized_official_last_name": "ENGEL",
        "authorized_official_first_name": "J",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-613-9191",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2010; 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.