Individual provider Active NPI

Nancy E Choe, OD

  • Optometrist
  • Jersey City, NJ
National Provider Identifier
1154417392
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00595700 Issued in NJ
Practice address
30 Mall Dr W
Jersey City, NJ 07310-1615
Phone
(201) 798-0303
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 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 27OA00595700 NJ Primary

Addresses

Primary practice location

30 Mall Dr W
Jersey City, NJ 07310-1615

Mailing address

6206 City PL
Edgewater, NJ 07020-3174
Phone (267) 974-7732

Other identifiers 1

IdentifierTypeStateIssuer
0050113MedicaidNJ

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
I20041222000664 NJ Practitioner - Optometry 9335107291 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Contact Lens and Vision Associates, P.a Optometrist CurrentSince Oct 20, 2010 Accepting new patients
Contact Lens and Vision Consultants, P.a Optometrist CurrentSince Oct 20, 2010 Accepting new patients
Supreme Solutions Inc Past Accepting new patients
Supreme Eye Center Inc Optometrist Past Accepting new patients

Locations

3710 Route 9 S
Ste 1501
Freehold, NJ 07728
Phone (732) 780-3000

161 A Woodbridge Ctr Dr
Woodbridge, NJ 07095
Phone (732) 698-1898

Organizations & group practices 4

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1154417392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6206 CITY PL",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070203174",
            "telephone_number": "267-974-7732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MALL DR W",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073101615",
            "telephone_number": "201-798-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOE",
        "first_name": "NANCY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00595700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0050113",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.