Organization Active NPI

Vincent R. Vicci, Jr. O.D., P.a.

  • Low Vision Rehabilitation Optometrist
  • Westfield, NJ
National Provider Identifier
1295934651
Registry record updated Apr 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Low Vision Rehabilitation OptometristTaxonomy code 152WL0500X
License
270A00416900 Issued in NJ
Legal business name
VINCENT R. VICCI, JR. O.D., P.A.
Practice address
592 Springfield Ave
Westfield, NJ 07090-1002
Phone
(908) 654-7950
Fax
(908) 654-7956
NPI assigned
Jul 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2013

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

Authorized official

Name
Dr. Vincent Richard Vicci Jr., O.D.NPI 1184781213
Title
Owner
Phone
(908) 654-7950

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Low Vision Rehabilitation OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152WL0500X 270A00416900 NJ Primary
Pediatric OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152WP0200X 270A00416900 NJ
Vision Therapy OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152WV0400X 270A00416900 NJ

Addresses

Primary practice location

592 Springfield Ave
Westfield, NJ 07090-1002

Mailing address

592 Springfield Ave
Westfield, NJ 07090-1002
Phone (908) 654-7950

Other identifiers 1

IdentifierTypeStateIssuer
093938OtherNJMEDICARE GROUP #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050909000037 NJ Part B Supplier - Clinic/Group Practice 3577507896 Receives reassigned benefits from 1 practitioner
Practice locations: Westfield, NJ

National Provider Directory

National Provider Directory

Locations

592 Springfield Ave
Westfield, NJ 07090
Phone (908) 301-0888

Practitioners & affiliated clinicians

Practitioners 1

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": "1184544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364947200000",
    "number": "1295934651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "592 SPRINGFIELD AVE",
            "city": "WESTFIELD",
            "state": "NJ",
            "postal_code": "070901002",
            "telephone_number": "908-654-7950",
            "fax_number": "908-654-7956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "592 SPRINGFIELD AVE",
            "city": "WESTFIELD",
            "state": "NJ",
            "postal_code": "070901002",
            "telephone_number": "908-654-7950",
            "fax_number": "908-654-7956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINCENT R. VICCI, JR. O.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-16",
        "last_updated": "2013-04-03",
        "status": "A",
        "authorized_official_last_name": "VICCI",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-654-7950",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "NJ",
            "license": "270A00416900",
            "primary": true
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Pediatrics",
            "state": "NJ",
            "license": "270A00416900",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "NJ",
            "license": "270A00416900",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "093938",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westfield, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2013; 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.