Organization Active NPI

Diana Zabarko OD LLC

  • Primary Care Clinic/Center
  • Wayne, NJ
National Provider Identifier
1336575158
Registry record updated Feb 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
27OA00583800 Issued in NJ
Legal business name
DIANA ZABARKO OD LLC
Practice address
1690 Ratzer Rd
Wayne, NJ 07470-2436
Phone
(917) 327-3811
Fax
(973) 904-3339
NPI assigned
Sep 25, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2014

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

Authorized official

Name
Diana ZabarkoNPI 1073611018
Title
Optometrist
Phone
(201) 797-2066

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
Primary Care Clinic/Center 261QP2300X 27OA00583800 NJ Primary

Addresses

Primary practice location

1690 Ratzer Rd
Wayne, NJ 07470-2436

Mailing address

286 Market St
Elmwood Park, NJ 07407-2014
Phone (201) 773-8885

Other identifiers 1

IdentifierTypeStateIssuer
9131809MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131211000085 NJ Part B Supplier - Clinic/Group Practice 6507093945 Receives reassigned benefits from 1 practitioner
Practice locations: Wayne, NJ

National Provider Directory

National Provider Directory

Locations

506 Hamburg Tpke
Ste 207
Wayne, NJ 07470
Phone (862) 336-1990

Practitioners & affiliated clinicians

Practitioners 2

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": "1380067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393286400000",
    "number": "1336575158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 MARKET ST",
            "city": "ELMWOOD PARK",
            "state": "NJ",
            "postal_code": "074072014",
            "telephone_number": "201-773-8885",
            "fax_number": "201-797-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 RATZER RD",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702436",
            "telephone_number": "917-327-3811",
            "fax_number": "973-904-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIANA ZABARKO OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-25",
        "last_updated": "2014-02-25",
        "status": "A",
        "authorized_official_last_name": "ZABARKO",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "201-797-2066"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NJ",
            "license": "27OA00583800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9131809",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2014; 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.