Organization Active NPI

Deyong's Eyeworld LLC

  • Optometrist
  • Colonia, NJ
National Provider Identifier
1396012910
Registry record updated Apr 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
270A00375500 Issued in NJ
Legal business name
DEYONG'S EYEWORLD LLC
Practice address
1009 Saint Georges Ave
Colonia, NJ 07067-4049
Phone
(732) 634-8600
NPI assigned
Nov 28, 2011
Last updated
Apr 3, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2020

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

Authorized official

Name
Dr. Alan ZastrowNPI 1609285568
Title
Optometrist
Phone
(732) 634-8600

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
Optometrist 152W00000X 270A00375500 NJ Primary

Addresses

Primary practice location

1009 Saint Georges Ave
Colonia, NJ 07067-4049

Mailing address

1009 Saint Georges Ave
Colonia, NJ 07067-4049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120417000230 NJ Part B Supplier - Clinic/Group Practice 3779744826 Receives reassigned benefits from 3 practitioners
Practice locations: Colonia, NJ
O20191121000341 NJ Part B Supplier - Clinic/Group Practice 8527490051 Receives reassigned benefits from 3 practitioners
Practice locations: Colonia, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1322438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585872000000",
    "number": "1396012910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 SAINT GEORGES AVE",
            "city": "COLONIA",
            "state": "NJ",
            "postal_code": "070674049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 SAINT GEORGES AVE",
            "city": "COLONIA",
            "state": "NJ",
            "postal_code": "070674049",
            "telephone_number": "732-634-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEYONG'S EYEWORLD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-28",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A",
        "authorized_official_last_name": "ZASTROW",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "732-634-8600",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "270A00375500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colonia, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; 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.