Organization Active NPI

Anderson Vision

  • Optometrist
  • Cliffside Park, NJ
National Provider Identifier
1215759055
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
ANDERSON VISION
Practice address
596 Anderson Ave Ste 101
Cliffside Park, NJ 07010-1872
Phone
(201) 943-0022
Fax
(201) 313-7146
NPI assigned
Oct 31, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Authorized official

Name
Dr. Marianna Tereschenko, ODNPI 1740374982
Title
Optometrist
Phone
(201) 681-6214

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

596 Anderson Ave Ste 101
Cliffside Park, NJ 07010-1872

Mailing address

596 Anderson Ave Ste 101
Cliffside Park, NJ 07010-1872
Phone (201) 943-0022

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241111001622 NJ Part B Supplier - Clinic/Group Practice 8921532102 Receives reassigned benefits from 1 practitioner
Practice locations: Cliffside Park, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1730332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1215759055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "596 ANDERSON AVE STE 101",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070101872",
            "telephone_number": "201-943-0022",
            "fax_number": "201-313-7146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "596 ANDERSON AVE STE 101",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070101872",
            "telephone_number": "201-943-0022",
            "fax_number": "201-313-7146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSON VISION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-31",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "TERESCHENKO",
        "authorized_official_first_name": "MARIANNA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "201-681-6214",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cliffside Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.