Individual provider Active NPI

Louise Colletti, O.D.

  • Optometrist
  • Woodbury, NJ
National Provider Identifier
1407851934
Registry record updated Jul 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27TO00095700 Issued in NJ
Practice address
661 N Broad St
Woodbury, NJ 08096-1621
Phone
(856) 845-7968
Fax
(856) 845-8544
NPI assigned
Jun 21, 2005
Last updated
Jul 1, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27TO00095700 NJ Primary

Addresses

Primary practice location

661 N Broad St
Woodbury, NJ 08096-1621

Mailing address

661 N Broad St
Woodbury, NJ 08096-1621
Phone (856) 845-7968

Other identifiers 2

IdentifierTypeStateIssuer
80372MedicaidNJ
3375218MedicaidNJ

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
I20050817000061 NJ Practitioner - Optometry 5193755429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Friedberg Eye Associates PAGroup PAC ID 5395896153, 8 clinicians

Practice addresses (Care Compare)

661 N Broad St
Woodbury, NJ 08096-1621
Phone (856) 845-7968

Merit-based Incentive Payment System (MIPS)

Final score
97.39 of 100Reported as group
Quality
94.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27TO00095700NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Friedberg Eye Associates PA Optometrist CurrentSince Aug 6, 1998 Accepting new patients
Friedberg Eye Associates PA PastSince Oct 1, 2021 Accepting new patients

Locations

412 Ewan Rd
Ste A
Mullica Hill, NJ 08062
Phone (856) 845-7968

5 Myers Dr
Ste 101
Mullica Hill, NJ 08062
Phone (856) 832-4802

661 N Broad St
Woodbury, NJ 08096
Phone (856) 845-7968

Interoperability endpoints

  • Direct secure messaging: lcolletti@friedbergeye.imwdirect.com

Organizations & group practices 2

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": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309478400000",
    "number": "1407851934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 N BROAD ST",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080961621",
            "telephone_number": "856-845-7968",
            "fax_number": "856-845-8544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 N BROAD ST",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080961621",
            "telephone_number": "856-845-7968",
            "fax_number": "856-845-8544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLETTI",
        "first_name": "LOUISE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-21",
        "last_updated": "2011-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27TO00095700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80372",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3375218",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NJ

Sources for this page

Verify at the official NPI Registry.