Individual provider Active NPI

Lydia Rosner-Rosen, O.D.

  • Optometrist
  • Paramus, NJ
National Provider Identifier
1124102470
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00526600 Issued in NJ
Practice address
322 Route 4 East
Paramus, NJ 07652
Phone
(201) 489-8868
Fax
(201) 489-9412
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OA00526600 NJ Primary

Addresses

Primary practice location

322 Route 4 East
Paramus, NJ 07652

Mailing address

322 Route 4 East
Paramus, NJ 07652
Phone (201) 489-8868

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
I20050808000161 NJ Practitioner - Optometry 8729017017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eyexam Group P aGroup PAC ID 8325224330, 3 clinicians

Practice addresses (Care Compare)

712 N State RT
Suite 17
Paramus, NJ 07652-3106
Phone (201) 262-7100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OA00526600NJMDOptometrist
005471NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Eyexam Group P a Optometrist CurrentSince Jan 26, 1994 Accepting new patients
Spring Valley Optical Inc. Optometrist PastSince Apr 15, 2010 Accepting new patients

Locations

322 E State Rt 4
Paramus, NJ 07652
Phone (201) 489-8484

712 N State Rt 17
Paramus, NJ 07652
Phone (201) 262-7100

340 N State Rt 17
Paramus, NJ 07652
Phone (201) 262-7100

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124102470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 ROUTE 4 EAST",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "07652",
            "telephone_number": "201-489-8868",
            "fax_number": "201-489-9412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 ROUTE 4 EAST",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "07652",
            "telephone_number": "201-489-8868",
            "fax_number": "201-489-9412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSNER-ROSEN",
        "first_name": "LYDIA",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00526600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paramus, NJ

Sources for this page

Verify at the official NPI Registry.