NPIMap

Organization Active NPI

NJ Eye and Ear LLC

  • Ophthalmology Physician
  • Englewood, NJ
National Provider Identifier
1356860811
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
NJ EYE AND EAR LLC
Practice address
17 W Palisade Ave
Englewood, NJ 07631-2705
Phone
(973) 546-5700
Fax
(800) 878-2811
NPI assigned
Sep 15, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Daniel Stegman, MDNPI 1740251040
Title
Owner
Phone
(973) 546-5700

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
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

17 W Palisade Ave
Englewood, NJ 07631-2705

Mailing address

17 W Palisade Ave
Englewood, NJ 07631-2705
Phone (973) 546-5700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171229000145 NJ Part B Supplier - Clinic/Group Practice 6002174737 Receives reassigned benefits from 51 practitioners
Practice locations: Clifton, NJ; Englewood, NJ

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

1016 Main Ave
Unit 2B
Clifton, NJ 07011

17 W Palisade Ave
Englewood, NJ 07631
Phone (973) 546-5700

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 52

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

View all 52

NPI Registry JSON

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

{
    "created_epoch": "1505433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1356860811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 W PALISADE AVE",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312705",
            "telephone_number": "973-546-5700",
            "fax_number": "800-878-2811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 W PALISADE AVE",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312705",
            "telephone_number": "973-546-5700",
            "fax_number": "800-878-2811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NJ EYE AND EAR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-15",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "STEGMAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-546-5700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.