Individual provider Active NPI

Peter Colangelo, O.D.

  • Optometrist
  • Princeton, NJ
National Provider Identifier
1447322417
Registry record updated Sep 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OA 4458 Issued in NJ
Practice address
3535 US Highway 1
Princeton Marketfair Suite 400
Princeton, NJ 08540-5903
Phone
(609) 520-1008
Fax
(609) 520-9279
NPI assigned
Nov 15, 2006
Last updated
Sep 15, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OA 4458 NJ Primary

Addresses

Primary practice location

3535 US Highway 1
Princeton Marketfair Suite 400
Princeton, NJ 08540-5903

Mailing address

4 Patricia Way
Kendall Park, NJ 08824-1806
Phone (732) 398-1354

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
I20110331000411 NJ Practitioner - Optometry 4789867508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Care Associates of PrincetonGroup PAC ID 5991924680, 6 clinicians

Practice addresses (Care Compare)

3535 Route 1
Suite 416
Princeton, NJ 08540-5974
Phone (609) 536-1017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OA 4458NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care Associates of Princeton Optometrist CurrentSince Jul 1, 2014 Accepting new patients
Dr. Jim I. Ciccarello & Eyecare Associates, PC Optometrist Past Accepting new patients

Locations

3535 US Highway 1
Ste 416
Princeton, NJ 08540
Phone (609) 520-1008

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284508800000",
    "number": "1447322417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 PATRICIA WAY",
            "city": "KENDALL PARK",
            "state": "NJ",
            "postal_code": "088241806",
            "telephone_number": "732-398-1354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 US HIGHWAY 1",
            "address_2": "PRINCETON MARKETFAIR SUITE 400",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085405903",
            "telephone_number": "609-520-1008",
            "fax_number": "609-520-9279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLANGELO",
        "first_name": "PETER",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2010-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "OA 4458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

Verify at the official NPI Registry.