Individual provider Active NPI

Rosemary Frasco, OD

  • Optometrist
  • Ridgewood, NJ
National Provider Identifier
1366558488
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0A5749 Issued in NJ
Practice address
625 Franklin Tpke
Ridgewood, NJ 07450
Phone
(201) 444-7770
Fax
(201) 445-2570
NPI assigned
Aug 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0A5749 NJ Primary
Optometrist 152W00000X 0PC3646 FL

Addresses

Primary practice location

625 Franklin Tpke
Ridgewood, NJ 07450

Mailing address

625 Franklin Tpke
Ridgewood, NJ 07450-1913
Phone (201) 444-7770

Other identifiers 1

IdentifierTypeStateIssuer
075505OtherMEDICARE GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040218000040 NJ Practitioner - Optometry 8123913290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Liva Eye Center LLCGroup PAC ID 4587559844, 3 clinicians

Practice addresses (Care Compare)

625 Franklin Tpke
Ridgewood, NJ 07450-1913
Phone (201) 444-7770

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0PC3646FLMDOptometrist
0A5749NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Liva Eye Center LLC CurrentSince May 30, 2001 Accepting new patients

Locations

1 W Ridgewood Ave
Ste 101
Paramus, NJ 07652
Phone (201) 444-7770

625 Franklin Tpke
Ridgewood, NJ 07450
Phone (201) 444-1441

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1366558488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 FRANKLIN TPKE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074501913",
            "telephone_number": "201-444-7770",
            "fax_number": "201-445-2570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 FRANKLIN TPKE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "07450",
            "telephone_number": "201-444-7770",
            "fax_number": "201-445-2570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRASCO",
        "first_name": "ROSEMARY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "0A5749",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "0PC3646",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "075505",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

Verify at the official NPI Registry.