New Jersey Eyecare Associates OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

4594 Issued in NJ

Legal business name

NEW JERSEY EYECARE ASSOCIATES OD PA

Practice address

1006 US Highway 46
Clifton, NJ 07013-2443

Phone

(973) 777-9296

Fax

(973) 777-9297

NPI assigned

Jan 23, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Bruce Mazie, O.D.NPI 1871578054

Title

President

Phone

(973) 777-9296

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Bruce Mazie, O.D.

  • Optometrist
  • Clifton, NJ
  • NPI 1871578054

  O20050202000012

  Same enrollment

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bruce Mazie, O.D.

  • Optometrist
  • Clifton, NJ
  • NPI 1871578054

  NJ

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612310400000",
    "number": "1164577193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 US HIGHWAY 46",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070132443",
            "telephone_number": "973-777-9296",
            "fax_number": "973-777-9297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 US HIGHWAY 46",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070132443",
            "telephone_number": "973-777-9296",
            "fax_number": "973-777-9297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW JERSEY EYECARE ASSOCIATES OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A",
        "authorized_official_last_name": "MAZIE",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-777-9296",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "4594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Clifton, NJ
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.