Individual provider Active NPI

Stephen Andrew Gollance, MD

  • Ophthalmology Physician
  • Wayne, NJ
National Provider Identifier
1215996517
Registry record updated Feb 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
25MA07932300 Issued in NJ
Practice address
968 Hamburg Tpke
Wayne, NJ 07470-3225
Phone
(973) 696-0300
Fax
(973) 696-0465
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 25MA07932300 NJ Primary

Addresses

Primary practice location

968 Hamburg Tpke
Wayne, NJ 07470-3225

Mailing address

968 Hamburg Tpke
Wayne, NJ 07470-3225
Phone (973) 696-0300

Other identifiers 1

IdentifierTypeStateIssuer
0077283MedicaidNJ

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
I20051103000091 NJ Practitioner - Ophthalmology 7810929825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Centers of America LLCGroup PAC ID 7315125184, 127 clinicians

Practice addresses (Care Compare)

1255 Broad St
Suite 104
Bloomfield, NJ 07003-3061
Phone (973) 707-5632

89 N Maple Ave
Suite 5
Ridgewood, NJ 07450-3235
Phone (201) 445-1991

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as group
Quality
96.31
Promoting interoperability
100
Improvement activities
40
Cost
73.39

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery125

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Centers of America, LLC Ophthalmology CurrentSince Sep 14, 2020 Accepting new patients

Locations

1255 Broad St
Ste 104
Bloomfield, NJ 07003
Phone (973) 707-5632

968 Hamburg Tpke
Wayne, NJ 07470
Phone (201) 696-0300

Interoperability endpoints

  • Direct secure messaging: sgollance@eaw.direct.iopracticeware.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265068800000",
    "number": "1215996517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "968 HAMBURG TPKE",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074703225",
            "telephone_number": "973-696-0300",
            "fax_number": "973-696-0465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "968 HAMBURG TPKE",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074703225",
            "telephone_number": "973-696-0300",
            "fax_number": "973-696-0465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLLANCE",
        "first_name": "STEPHEN",
        "middle_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2010-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "25MA07932300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0077283",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

Verify at the official NPI Registry.