Spiro Antonacos

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA00511900 Issued in NJ

Practice address

582 Central Ave
East Orange, NJ 07018-1936

Phone

(973) 673-7700

Fax

(973) 674-3943

NPI assigned

Mar 29, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Tko Optical Inc.

  • Eyewear Supplier
  • East Orange, NJ
  • NPI 1356512511
  NPD (past)

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213920000000",
    "number": "1174643688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 FOREST HILL RD",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524518",
            "telephone_number": "973-669-9888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "582 CENTRAL AVE",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070181936",
            "telephone_number": "973-673-7700",
            "fax_number": "973-674-3943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONACOS",
        "first_name": "SPIRO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2008-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00511900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4997000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angel Support Coordination LLC
• Angelic Home and Health Care Services
• Lucy Ankrah, APN
• Christine Annunziata
• Roland Antoine, M.D.
• Apollo Healthcare LLC (Goodlife Adult Day Care Center LLC)
• Kayla Apple
• Arcanum Medical
• Archway Rehabilitation Center, LLC
• Martha Cecilia Arismendy, PA

• Optometrist in East Orange, NJ
• Providers in East Orange, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.