Individual provider Active NPI

Joseph Lebovic, OD

  • Optometrist
  • Camden, NJ
National Provider Identifier
1083657936
Registry record updated Aug 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00376900 Issued in NJ
Practice address
2985 Yorkship SQ
Camden, NJ 08104-2800
Phone
(856) 964-2020
Fax
(856) 964-1060
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OA00376900 NJ Primary
Optometrist 152W00000X OE005265P PA

Addresses

Primary practice location

2985 Yorkship SQ
Camden, NJ 08104-2800

Mailing address

2985 Yorkship SQ
Camden, NJ 08104-2800
Phone (856) 964-2020

Other identifiers 1

IdentifierTypeStateIssuer
3897605MedicaidNJ

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
I20050729000051 NJ Practitioner - Optometry 0547298739 Reassigns benefits to 1 organization
Practice locations: Camden, NJ

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tus Ojos IncGroup PAC ID 2365414679, 4 clinicians

Practice addresses (Care Compare)

1000 Atlantic Ave
Camden, NJ 08104-1132
Phone (856) 365-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OE005265PPAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Tus Ojos Inc Optometrist CurrentSince Mar 1, 2020 Accepting new patients

Locations

1000 Atlantic Ave
Camden, NJ 08104
Phone (856) 246-3060

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312243200000",
    "number": "1083657936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2985 YORKSHIP SQ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081042800",
            "telephone_number": "856-964-2020",
            "fax_number": "856-964-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2985 YORKSHIP SQ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081042800",
            "telephone_number": "856-964-2020",
            "fax_number": "856-964-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBOVIC",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2011-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00376900",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OE005265P",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3897605",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.