Organization Active NPI

Moorestown Eye Associates

  • Optometrist
  • Moorestown, NJ
National Provider Identifier
1194771634
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MOORESTOWN EYE ASSOCIATES
Practice address
301 N Church St
Ste 201
Moorestown, NJ 08057-2498
Phone
(856) 235-2620
NPI assigned
May 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Dr. Les Friedman, OD
Title
LLC Member
Phone
(856) 235-2620

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X NJ Primary

Addresses

Primary practice location

301 N Church St
Ste 201
Moorestown, NJ 08057-2498

Mailing address

301 N Church St
Ste 201
Moorestown, NJ 08057-2498
Phone (856) 235-2620

Other identifiers 4

IdentifierTypeStateIssuer
0415179000OtherNJAMERIHEALTH ADMINISTRATOR
960912OtherNJAMERIHEALTH PERSONAL CHOI
0415179000OtherNJKEYSTONE
0415179000OtherNJAMERIHEALTH HMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050222000608 NJ Part B Supplier - Clinic/Group Practice 4587617360 Receives reassigned benefits from 6 practitioners
Practice locations: Moorestown, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2090523Moorestown Eye Associates LLC301 N Church Street, Moorestown, NJ 08057Certificate of waiverJan 25, 2027

National Provider Directory

National Provider Directory

Locations

301 N Church St
Ste 201
Moorestown, NJ 08057
Phone (856) 235-2620

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1194771634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N CHURCH ST",
            "address_2": "STE 201",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080572498",
            "telephone_number": "856-235-2620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N CHURCH ST",
            "address_2": "STE 201",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080572498",
            "telephone_number": "856-235-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOORESTOWN EYE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "FRIEDMAN",
        "authorized_official_first_name": "LES",
        "authorized_official_title_or_position": "LLC MEMBER",
        "authorized_official_telephone_number": "856-235-2620",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH ADMINISTRATOR",
            "identifier": "0415179000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH PERSONAL CHOI",
            "identifier": "960912",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE",
            "identifier": "0415179000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH HMO",
            "identifier": "0415179000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorestown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 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.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.