Organization Active NPI

JG Optical Inc.

  • Optician
  • Bloomfield, NJ
National Provider Identifier
1083780175
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
TD3340 Issued in NJ
Legal business name
JG OPTICAL INC.
Practice address
108 Broughton Ave
Bloomfield, NJ 07003
Phone
(973) 743-1353
Fax
(973) 743-6577
NPI assigned
Nov 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Authorized official

Name
Dr. Joshua Gould, D.O.NPI 1043238876
Title
President
Phone
(973) 743-1353

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
OpticianGroup: 193200000X MULTI-SPECIALTY GROUP 156FX1800X TD3340 NJ Primary

Addresses

Primary practice location

108 Broughton Ave
Bloomfield, NJ 07003

Mailing address

108 Broughton Ave
Bloomfield, NJ 07003-3989
Phone (973) 743-1353

Other identifiers 1

IdentifierTypeStateIssuer
300090701MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930088578 NJ DME Supplier - Optician 9537286505 Practice locations: Bloomfield, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
JG Optical Inc.108 Broughton Ave, Bloomfield, NJ 07003-3989(973) 743-1353 Prosthetic Lenses: Conventional Eyeglasses Does not accept assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
JG Optical Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719273600000",
    "number": "1083780175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 BROUGHTON AVE",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070033989",
            "telephone_number": "973-743-1353",
            "fax_number": "973-743-6577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 BROUGHTON AVE",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "07003",
            "telephone_number": "973-743-1353",
            "fax_number": "973-743-6577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JG OPTICAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A",
        "authorized_official_last_name": "GOULD",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-743-1353",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "NJ",
            "license": "TD3340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300090701",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.