Individual provider Active NPI

Mariam Aslami, O.D.

  • Optometrist
  • Wayne, NJ
National Provider Identifier
1205289790
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00716800 Issued in NJ
Practice address
1508 Willowbrook Mall
Wayne, NJ 07470
Phone
(973) 256-0060
NPI assigned
Jul 19, 2016
Last updated
Dec 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT33414 TLG CA
Optometrist 152W00000X 27OA00716800 NJ Primary

Addresses

Primary practice location

1508 Willowbrook Mall
Wayne, NJ 07470

Mailing address

1508 Willowbrook Mall
Wayne, NJ 07470
Phone (973) 256-0060

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230404000346 NJ Practitioner - Optometry 0749560944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Modern Vue EyecareGroup PAC ID 3375918493, 2 clinicians

Practice addresses (Care Compare)

1508 Willowbrook Mall
Wayne, NJ 07470-6906
Phone (973) 256-0060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT33414 TLGCAMDOptometrist
33414CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Vue Eyecare CurrentSince Oct 22, 2022 Accepting new patients

Locations

1508 Willowbrook Mall
Wayne, NJ 07470
Phone (973) 256-0060

1508 Willowbrook Mall
Wayne, NJ 07470
Phone (973) 256-0060

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1205289790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 WILLOWBROOK MALL",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "07470",
            "telephone_number": "973-256-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 WILLOWBROOK MALL",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "07470",
            "telephone_number": "973-256-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASLAMI",
        "first_name": "MARIAM",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-19",
        "last_updated": "2022-12-22",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT33414 TLG",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00716800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

Verify at the official NPI Registry.