Organization Active NPI

Pink Vision Associates LLC

  • Optometrist
  • Irvington, NJ
National Provider Identifier
1417248949
Registry record updated Jan 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00630100 Issued in NJ
Legal business name
PINK VISION ASSOCIATES LLC
Practice address
1068 Clinton Ave
Irvington, NJ 07111-3501
Phone
(973) 399-0909
NPI assigned
May 2, 2011
Last updated
Jan 23, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2013

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

Authorized official

Name
Dr. Maria Domingues, O.D.NPI 1174820682
Title
Optometrist
Phone
(973) 399-0909

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 27OA00630100 NJ Primary

Addresses

Primary practice location

1068 Clinton Ave
Irvington, NJ 07111-3501

Mailing address

1068 Clinton Ave
Irvington, NJ 07111-3501
Phone (973) 399-0909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110919000453 NJ Part B Supplier - Clinic/Group Practice 6002087343 Receives reassigned benefits from 4 practitioners
Practice locations: Kearny, NJ; Summit, NJ; Lyndhurst, NJ; Irvington, NJ; Fort Lee, NJ

National Provider Directory

National Provider Directory

Locations

1562 Lemoine Ave
Ste 3
Fort Lee, NJ 07024
Phone (201) 461-7595

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": "1304294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358899200000",
    "number": "1417248949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1068 CLINTON AVE",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071113501",
            "telephone_number": "973-399-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1068 CLINTON AVE",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071113501",
            "telephone_number": "973-399-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINK VISION ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-02",
        "last_updated": "2013-01-23",
        "status": "A",
        "authorized_official_last_name": "DOMINGUES",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "973-399-0909",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00630100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvington, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2013; 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.