Active NPI
Evan Gee Young Joo
- Optometrist
- Fort Lee, NJ
National Provider Identifier
1255536736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 27OA00581500
- Practice address
- 215 Main St
Fort Lee, NJ 07024-5701 - Phone
- (201) 944-9889
- Fax
- (201) 944-9989
- NPI assigned
- Jun 15, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 27OA00581500 | NJ | Primary |
Addresses
Primary practice location
215 Main St
Fort Lee, NJ 07024-5701
Mailing address
215 Main St
Fort Lee, NJ 07024-5701
Phone (201) 944-9889
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0053520 | Medicaid | NJ |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pennsylvania College of Optometry, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
215 Main St
Suite 1
Fort Lee, NJ 07024-5722
Phone (201) 944-9889
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27OA00581500 | NJ | MD | Optometrist |
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": "1181865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1255536736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 MAIN ST",
"city": "FORT LEE",
"state": "NJ",
"postal_code": "070245701",
"telephone_number": "201-944-9889",
"fax_number": "201-944-9989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 MAIN ST",
"city": "FORT LEE",
"state": "NJ",
"postal_code": "070245701",
"telephone_number": "201-944-9889",
"fax_number": "201-944-9989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOO",
"first_name": "EVAN",
"middle_name": "GEE YOUNG",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NJ",
"license": "27OA00581500",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0053520",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Lee, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.