Individual provider Active NPI

Elena Martinez, O.D

  • Optometrist
  • Sparta, NJ
National Provider Identifier
1093166290
Registry record updated Jun 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00666600 Issued in NJ
Practice address
117 Sparta Ave
Sparta, NJ 07871-1773
Phone
(973) 726-0669
NPI assigned
Jun 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OA00666600 NJ Primary
Optometrist 152W00000X 27OM00134600 NJ

Addresses

Primary practice location

117 Sparta Ave
Sparta, NJ 07871-1773

Mailing address

117 Sparta Ave
Sparta, NJ 07871-1773
Phone (973) 726-0669

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
I20160722000081 NJ Practitioner - Optometry 7810280294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Optometry Group PAGroup PAC ID 0648296418, 5 clinicians

Practice addresses (Care Compare)

117 Sparta Ave
Sparta, NJ 07871-1773
Phone (973) 729-9199

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OM00134600NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Optometry Group, P.a. Optometrist CurrentSince Jun 28, 2016 Accepting new patients
Northwest Optometry Group, P.a. Optometrist CurrentSince Jun 28, 2016 Accepting new patients

Locations

200 US Highway 206
Branchville, NJ 07826
Phone (973) 948-7272

438 County Road 513
Califon, NJ 07830
Phone (908) 832-2099

117 Sparta Ave
Sparta, NJ 07871
Phone (973) 726-0669

145 State Route 183
Stanhope, NJ 07874
Phone (973) 347-8877

Organizations & group practices 2

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": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467158400000",
    "number": "1093166290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 SPARTA AVE",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078711773",
            "telephone_number": "973-726-0669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 SPARTA AVE",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078711773",
            "telephone_number": "973-726-0669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "ELENA",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-29",
        "last_updated": "2016-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00666600",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OM00134600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparta, NJ

Sources for this page

Verify at the official NPI Registry.