Organization Active NPI

The Eye Clinic NJ

Doing business as Eye Clinic PA

  • Ophthalmology Physician
  • Union, NJ
National Provider Identifier
1467539791
Registry record updated Feb 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
THE EYE CLINIC NJ
Doing business as
Eye Clinic PA
Practice address
1095 Morris Ave Ste 400
Liberty Hall II
Union, NJ 07083
Phone
(908) 686-2525
Fax
(908) 947-0630
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2020

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

Authorized official

Name
Mrs. Anabela Rodrigues
Title
Administrator
Phone
(908) 686-2525

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X NJ Primary

Addresses

Primary practice location

1095 Morris Ave Ste 400
Liberty Hall II
Union, NJ 07083

Mailing address

1095 Morris Ave Ste 400
Liberty Hall II
Union, NJ 07083
Phone (908) 686-2525

Other identifiers 2

IdentifierTypeStateIssuer
142378OtherNJMEDICATE
2697505MedicaidNJ

Other names 1

  • Eye Clinic PA Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070802000496 NJ Part B Supplier - Clinic/Group Practice 8921199183 Receives reassigned benefits from 4 practitioners
Practice locations: Union, NJ

National Provider Directory

National Provider Directory

Locations

155 Jefferson St
Newark, NJ 07105
Phone (973) 344-5498

1095 Morris Ave
Ste 400
Union, NJ 07083
Phone (908) 686-2525

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582675200000",
    "number": "1467539791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1095 MORRIS AVE STE 400",
            "address_2": "LIBERTY HALL II",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "07083",
            "telephone_number": "908-686-2525",
            "fax_number": "908-947-0630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 MORRIS AVE STE 400",
            "address_2": "LIBERTY HALL II",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "07083",
            "telephone_number": "908-686-2525",
            "fax_number": "908-947-0630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE EYE CLINIC NJ",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A",
        "authorized_official_last_name": "RODRIGUES",
        "authorized_official_first_name": "ANABELA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "908-686-2525",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICATE",
            "identifier": "142378",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2697505",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Clinic PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Union, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.