NPIMap

Organization Active NPI

Optical World of Elizabeth LLC

  • Optometrist
  • Elizabeth, NJ
National Provider Identifier
1366455032
Registry record updated Dec 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
OPTICAL WORLD OF ELIZABETH LLC
Practice address
206 Broad St
Elizabeth, NJ 07201-2304
Phone
(908) 629-0011
Fax
(908) 629-1133
NPI assigned
Aug 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2008

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

Authorized official

Name
Mukul C Raithatha
Title
President
Phone
(908) 629-0011

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

206 Broad St
Elizabeth, NJ 07201-2304

Mailing address

206 Broad St
Elizabeth, NJ 07201-2304
Phone (908) 629-0011

Other identifiers 3

IdentifierTypeStateIssuer
28188OtherNJSPECTERA
51599OtherNJDAVIS VISION
0072460MedicaidNJ

National Provider Directory

National Provider Directory

Locations

206 Broad St
Elizabeth, NJ 07201
Phone (908) 629-0011

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": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228176000000",
    "number": "1366455032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 BROAD ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072012304",
            "telephone_number": "908-629-0011",
            "fax_number": "908-629-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 BROAD ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072012304",
            "telephone_number": "908-629-0011",
            "fax_number": "908-629-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTICAL WORLD OF ELIZABETH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2008-12-02",
        "status": "A",
        "authorized_official_last_name": "RAITHATHA",
        "authorized_official_first_name": "MUKUL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "908-629-0011"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "28188",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "51599",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0072460",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.