Organization Active NPI

Dr Van Vinciguerra Optometry, P.C.

  • Optometrist
  • Cliffside Park, NJ
National Provider Identifier
1255008512
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DR VAN VINCIGUERRA OPTOMETRY, P.C.
Practice address
740 Anderson Ave
Cliffside Park, NJ 07010-2137
Phone
(201) 313-0303
Fax
(201) 313-9461
NPI assigned
Aug 25, 2021
Last updated
Aug 27, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2021

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

Authorized official

Name
Van VinciguerraNPI 1467445171
Title
Principal & Optometrist
Phone
(201) 313-0303

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
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

740 Anderson Ave
Cliffside Park, NJ 07010-2137

Mailing address

740 Anderson Ave
Cliffside Park, NJ 07010-2137
Phone (201) 313-0303

Other practice location 1

158 Market St
Paterson, NJ 07505-1702
Phone (973) 684-1545

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210928000250 NJ Part B Supplier - Clinic/Group Practice 7911304365 Receives reassigned benefits from 6 practitioners
Practice locations: Cliffside Park, NJ; Paterson, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630022400000",
    "number": "1255008512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 ANDERSON AVE",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070102137",
            "telephone_number": "201-313-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 ANDERSON AVE",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070102137",
            "telephone_number": "201-313-0303",
            "fax_number": "201-313-9461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "158 Market St",
            "address_purpose": "LOCATION",
            "city": "Paterson",
            "state": "NJ",
            "postal_code": "075051702",
            "country_code": "US",
            "telephone_number": "973-684-1545",
            "fax_number": "973-345-6120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DR VAN VINCIGUERRA OPTOMETRY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-25",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A",
        "authorized_official_last_name": "VINCIGUERRA",
        "authorized_official_first_name": "VAN",
        "authorized_official_title_or_position": "PRINCIPAL & OPTOMETRIST",
        "authorized_official_telephone_number": "201-313-0303"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "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 Aug 27, 2021; 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.