Jacquetta Edwards, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA004989 Issued in NJ

Practice address

279 Ferry St
Newark, NJ 07105-3400

Phone

(973) 344-2212

NPI assigned

Sep 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Optometry

Education

State University of New York - State College Optometry, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tus Ojos IncGroup PAC ID 2365414679, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Tus Ojos Inc

  • Optometrist
  • Philadelphia, PA
  • NPI 1831291814

  NJ

  Medicare reassignment Care Compare group NPD
• Millenium Eye Care, LLC

  • Optometrist
  • Newark, NJ
  • NPI 1598988974
  NPD (past)

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1487747887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 KAPKOWSKI RD",
            "address_2": "SUITE 1236",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072014901",
            "telephone_number": "908-354-1077",
            "fax_number": "908-354-1344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 FERRY ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071053400",
            "telephone_number": "973-344-2212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 Ferry St",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071052106",
            "country_code": "US",
            "telephone_number": "973-589-8085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "JACQUETTA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-30",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA004989",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OM00119300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Husham A Edani, DENTIST
• Osamuede Folorunsho Edobor-Osula, M.D.
• Izevbuwa O. Edokpolor
• Obunike O Edokwe, MD
• Cassandra Edouard, LCSW
• Johnathan Edwards
• Maureen Rena Edwards, LSW
• Tyanda Edwards
• Mercy K. Edziah, MS, RD, CDCES
• Eero Therapeutic Services LLC

• Optometrist in Newark, NJ
• Providers in Newark, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.