Organization Active NPI

Long Valley Eye Care, LLC

  • Optometrist
  • Long Valley, NJ
National Provider Identifier
1265632251
Registry record updated Jan 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4830 Issued in NJ
Legal business name
LONG VALLEY EYE CARE, LLC
Practice address
62 E Mill Rd
C-8
Long Valley, NJ 07853-3118
Phone
(908) 876-9955
Fax
(908) 876-1055
NPI assigned
Jul 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2012

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

Authorized official

Name
Dr. Christopher D Moore, ODNPI 1952376543
Title
Owner
Phone
(908) 876-9955

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 4830 NJ Primary

Addresses

Primary practice location

62 E Mill Rd
C-8
Long Valley, NJ 07853-3118

Mailing address

62 E Mill Rd
C-8
Long Valley, NJ 07853-3118
Phone (908) 876-9955

Other identifiers 1

IdentifierTypeStateIssuer
124036OtherNJMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080509000019 NJ Part B Supplier - Clinic/Group Practice 7618056128 Receives reassigned benefits from 3 practitioners
Practice locations: Long Valley, NJ

National Provider Directory

National Provider Directory

Locations

62 E Mill Rd
Ste C8
Long Valley, NJ 07853
Phone (908) 876-9955

62 E Mill Rd
Ste C4
Long Valley, NJ 07853
Phone (908) 876-9955

Practitioners & affiliated clinicians

Practitioners 3

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": "1184803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327363200000",
    "number": "1265632251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 E MILL RD",
            "address_2": "C-8",
            "city": "LONG VALLEY",
            "state": "NJ",
            "postal_code": "078533118",
            "telephone_number": "908-876-9955",
            "fax_number": "908-876-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 E MILL RD",
            "address_2": "C-8",
            "city": "LONG VALLEY",
            "state": "NJ",
            "postal_code": "078533118",
            "telephone_number": "908-876-9955",
            "fax_number": "908-876-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG VALLEY EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-19",
        "last_updated": "2012-01-24",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-876-9955",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "4830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "124036",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Valley, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; 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.