Individual provider Active NPI

David L. Rajkowski, O.D.

  • Optometrist
  • North Haledon, NJ
National Provider Identifier
1386622140
Registry record updated Jan 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OA5324 Issued in NJ
Practice address
33 Sicomac Rd
Suite 204
North Haledon, NJ 07508-2971
Phone
(973) 427-7801
Fax
(973) 427-7969
NPI assigned
Jan 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OA5324 NJ Primary

Addresses

Primary practice location

33 Sicomac Rd
Suite 204
North Haledon, NJ 07508-2971

Mailing address

33 Sicomac Rd
Suite 204
North Haledon, NJ 07508-2971
Phone (973) 427-7801

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
I20090304000749 NJ Practitioner - Optometry 1456417161 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maple Eyecare, LLCGroup PAC ID 6709942410, 5 clinicians
High Mountain Eyecare, LLCGroup PAC ID 7618923798, 3 clinicians

Practice addresses (Care Compare)

190 Dayton St
Suite 2
Ridgewood, NJ 07450-4425
Phone (201) 444-3173

33 Sicomac Rd
North Haledon, NJ 07508-2971
Phone (973) 427-7801

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
OA5324NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
River Vale Eyecare Optometrist CurrentSince May 1, 2023 Accepting new patients
High Mountain Eyecare, LLC Optometrist CurrentSince May 4, 1995 Accepting new patients
Maple Eyecare, LLC Optometrist CurrentSince Dec 1, 2008 Accepting new patients

Locations

33 Sicomac Rd
North Haledon, NJ 07508
Phone (973) 427-0300

33 Sicomac Rd
Ste 204
North Haledon, NJ 07508
Phone (973) 427-7801

190 Dayton St
Ste 2
Ridgewood, NJ 07450
Phone (201) 444-3173

688 Westwood Ave
Ste 2
River Vale, NJ 07675
Phone (201) 596-4040

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200960000000",
    "number": "1386622140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 SICOMAC RD",
            "address_2": "SUITE 204",
            "city": "NORTH HALEDON",
            "state": "NJ",
            "postal_code": "075082971",
            "telephone_number": "973-427-7801",
            "fax_number": "973-427-7969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 SICOMAC RD",
            "address_2": "SUITE 204",
            "city": "NORTH HALEDON",
            "state": "NJ",
            "postal_code": "075082971",
            "telephone_number": "973-427-7801",
            "fax_number": "973-427-7969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJKOWSKI",
        "first_name": "DAVID",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2008-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "OA5324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Haledon, NJ

Sources for this page

Verify at the official NPI Registry.