Steven Paul Wetcher, O.D.
Individual provider Active NPI Optometrist · Green Village, NJ
NPI 1194789529 · NPPES record last updated Apr 22, 2008
Key facts
- NPI
- 1194789529
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 27TO00018800 (NJ)
- Practice address
- 268 Green Village Rd
Green Village, NJ 07935-3027 - Phone
- (973) 822-8199
- Fax
- (973) 660-0420
- NPI assigned
- Apr 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- State University of New York - State College Optometry, 1977
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
268 Green Village Rd
Green Village, NJ 07935-3027
Phone (973) 822-8199
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050802000411 | NJ | Practitioner - Optometry | 9537197355 | Practice locations: Green Village, NJ |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3775 | NJ | MD | Psychologist |
| 27TO00018800 | NJ | MD | Optometrist |
| T003597-1 | NY | MD | Optometrist |
| OE005311P | PA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nutrition Source Consulting LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 27OA00377500 | NJ | |
| Optometrist | 152W00000X | 27TO00018800 | NJ | Yes |
| Optometrist | 152W00000X | OE005311P | PA | |
| Optometrist | 152W00000X | T003597-1 | NY |
Addresses
Primary practice location
268 Green Village Rd
Green Village, NJ 07935-3027
Mailing address
PO Box 283
Green Village, NJ 07935-0283
Phone (973) 822-8199
Other providers in Green Village, NJ
All providers in Green Village, NJ · Optometrist in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 22, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.