Super Vision LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA00615400 Issued in NJ

Legal business name

SUPER VISION LLC

Practice address

461 Central Ave
Jersey City, NJ 07307-2740

Phone

(201) 420-0101

Fax

(201) 420-1123

NPI assigned

Dec 8, 2010

Organization subpart

No

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

Authorized official

Name

Sunny Mukul RaithathaNPI 1679240329

Title

Owner

Phone

(201) 724-2227

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sunny Mukul Raithatha

  • Optometrist
  • Jersey City, NJ
  • NPI 1679240329
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1291766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747180800000",
    "number": "1295038552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 CENTRAL AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073072740",
            "telephone_number": "201-420-0101",
            "fax_number": "201-420-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 CENTRAL AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073072740",
            "telephone_number": "201-420-0101",
            "fax_number": "201-420-1123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPER VISION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-08",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A",
        "authorized_official_last_name": "RAITHATHA",
        "authorized_official_first_name": "SUNNY",
        "authorized_official_middle_name": "MUKUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-724-2227"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00615400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2Y1165",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Xinyu Sun, MA
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• Sai Sujana Surapaneni, PHARMACIST
• Varsha Vallapuzha Suresh
• Surgicare Surgical Associates of Jersey City, LLC

• Optometrist in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; 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.