Individual provider Active NPI

Colleen Maturana, M.D.

  • Ophthalmology Physician
  • New York, NY
National Provider Identifier
1174905202
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
25MA11374900 Issued in NJ
Practice address
1305 York Ave FL 11
New York, NY 10021-5663
Phone
(646) 962-2020
Fax
(646) 962-0602
NPI assigned
Jun 25, 2015
Last updated
Nov 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Ophthalmology Physician 207W00000X 25MA11374900 NJ Primary
Glaucoma Specialist (Ophthalmology) Physician 207WX0009X 298933-1 NY

Addresses

Primary practice location

1305 York Ave FL 11
New York, NY 10021-5663

Mailing address

1305 York Ave FL 11
New York, NY 10021-5663
Phone (646) 962-2020

Other practice location 1

259 1st St
Mineola, NY 11501-3957
Phone (908) 461-7047

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220623001762 NJ Practitioner - Ophthalmology 4486990363 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
New York University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ophthalmology NJ LLCGroup PAC ID 2668820440, 12 clinicians

Practice addresses (Care Compare)

400 Valley Rd
Suite 106
Mt Arlington, NJ 07856-2316
Phone (973) 584-4451

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.02 of 100Reported as group
Quality
96.62
Improvement activities
40
Cost
61.23

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery185

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA11374900NJMDOphthalmology Physician
298933-1NYMDGlaucoma Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Roxbury Eye Center PC Ophthalmology CurrentSince Mar 16, 2022 Accepting new patients
Ophthalmology NJ LLC Ophthalmology CurrentSince Jan 1, 2024 Accepting new patients
Ophthalmology NJ LLC Ophthalmology CurrentSince Jan 1, 2024 Accepting new patients

Locations

5 Franklin Ave
Ste 209
Belleville, NJ 07109
Phone (973) 751-6060

16 Pocono Rd
Ste 212
Denville, NJ 07834
Phone (862) 209-1122

400 Valley Rd
Ste 106
Mt Arlington, NJ 07856
Phone (973) 584-4451

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1174905202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 YORK AVE FL 11",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100215663",
            "telephone_number": "646-962-2020",
            "fax_number": "646-962-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 YORK AVE FL 11",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100215663",
            "telephone_number": "646-962-2020",
            "fax_number": "646-962-0602"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "259 1st St",
            "address_purpose": "LOCATION",
            "city": "Mineola",
            "state": "NY",
            "postal_code": "115013957",
            "country_code": "US",
            "telephone_number": "908-461-7047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATURANA",
        "first_name": "COLLEEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-25",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "25MA11374900",
            "primary": true
        },
        {
            "code": "207WX0009X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "NY",
            "license": "298933-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.