Individual provider Active NPI

Fatima Lucila Constante-Gonzalez, O.D.,

  • Optometrist
  • Clifton, NJ
National Provider Identifier
1457516106
Registry record updated Feb 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00613600 Issued in NJ
Practice address
251 Clifton Ave
Clifton, NJ 07011-1961
Phone
(973) 340-2300
NPI assigned
Jul 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OA00613600 NJ Primary

Addresses

Primary practice location

251 Clifton Ave
Clifton, NJ 07011-1961

Mailing address

53 47TH St Apt 4R
Weehawken, NJ 07086-7144

Other practice location 1

517 41st St
Union City, NJ 07087-3793
Phone (201) 866-2440

Other identifiers 1

IdentifierTypeStateIssuer
27OA00613600OtherNJNJ LICENSE

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
I20090603000275 NJ Practitioner - Optometry 8325198906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charles M Cummins, OD, PAGroup PAC ID 0446246995, 24 clinicians

Practice addresses (Care Compare)

251 Clifton Ave
Clifton, NJ 07011-1961
Phone (973) 340-2300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OA00613600NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Charles M Cummins, OD, PA Optometrist CurrentSince May 12, 2018 Accepting new patients
Charles M. Cummins, OD., PA Optometrist CurrentSince May 12, 2018 Accepting new patients

Locations

1255 Broad St
Bloomfield, NJ 07003
Phone (973) 338-7575

588 Route 70
Ste 9
Brick, NJ 08723
Phone (732) 864-0755

251 Clifton Ave
Clifton, NJ 07011
Phone (973) 340-2300

550 Old Post Rd
Edison, NJ 08817
Phone (732) 287-6600

501 N Route 17
Paramus, NJ 07652
Phone (201) 265-9400

500 Route 23
Ste 7
Pompton Plains, NJ 07444
Phone (973) 616-7171

120 Route 22
Springfield, NJ 07081
Phone (973) 379-5063

157 State Route 10 E
Succasunna, NJ 07876
Phone (973) 927-7717

255 US Highway 46
Totowa, NJ 07512
Phone (973) 785-8000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1457516106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 47TH ST APT 4R",
            "city": "WEEHAWKEN",
            "state": "NJ",
            "postal_code": "070867144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 CLIFTON AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070111961",
            "telephone_number": "973-340-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "517 41st St",
            "address_purpose": "LOCATION",
            "city": "Union City",
            "state": "NJ",
            "postal_code": "070873793",
            "country_code": "US",
            "telephone_number": "201-866-2440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONSTANTE-GONZALEZ",
        "first_name": "FATIMA",
        "middle_name": "LUCILA",
        "name_prefix": "Dr.",
        "credential": "O.D.,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-22",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00613600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ LICENSE",
            "identifier": "27OA00613600",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

Verify at the official NPI Registry.