Individual provider Active NPI

John R Favetta, MD

  • Ophthalmology Physician
  • North Arlington, NJ
National Provider Identifier
1497861090
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
25MA03185400 Issued in NJ
Practice address
70 Ridge Rd
North Arlington, NJ 07031-6318
Phone
(201) 997-2332
Fax
(201) 997-6845
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 25MA03185400 NJ Primary

Addresses

Primary practice location

70 Ridge Rd
North Arlington, NJ 07031-6318

Mailing address

1255 Broad St Ste 104
Bloomfield, NJ 07003-3061
Phone (973) 707-5632

Other identifiers 1

IdentifierTypeStateIssuer
3037908MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jfavetta@retinanj.intellechartdirect.net Eye Centers Of America, LLC

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040117000013 NJ Practitioner - Ophthalmology 0941101455 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Rutgers New Jersey Medical School, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Centers of America LLCGroup PAC ID 7315125184, 127 clinicians
County of EssexGroup PAC ID 7214837061, 11 clinicians

Practice addresses (Care Compare)

1255 Broad St
Suite 104
Bloomfield, NJ 07003-3061
Phone (973) 707-5632

204 Grove Ave
Cedar Grove, NJ 07009-1436
Phone (973) 571-2833

89 N Maple Ave
Suite 5
Ridgewood, NJ 07450-3235
Phone (201) 445-1991

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as group
Quality
96.31
Promoting interoperability
100
Improvement activities
40
Cost
73.39

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
County of Essex Current Accepting new patients
County of Essex CurrentSince Jan 1, 1989 Accepting new patients
Eye Centers of America, LLC Ophthalmology CurrentSince Oct 9, 2018 Accepting new patients
County of Essex Current Accepting new patients
County of Essex Current Accepting new patients

Locations

1255 Broad St
Ste 104
Bloomfield, NJ 07003
Phone (973) 707-5632

108 Broughton Ave
Bloomfield, NJ 07003
Phone (973) 743-1331

204 Grove Ave
Cedar Grove, NJ 07009
Phone (973) 571-2800

62 Ridge Rd
North Arlington, NJ 07031
Phone (201) 991-6509

70 Ridge Rd
North Arlington, NJ 07031
Phone (201) 997-2332

Organizations & group practices 5

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1497861090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 BROAD ST STE 104",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070033061",
            "telephone_number": "973-707-5632",
            "fax_number": "866-806-3675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 RIDGE RD",
            "city": "NORTH ARLINGTON",
            "state": "NJ",
            "postal_code": "070316318",
            "telephone_number": "201-997-2332",
            "fax_number": "201-997-6845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAVETTA",
        "first_name": "JOHN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "25MA03185400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3037908",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jfavetta@retinanj.intellechartdirect.net",
            "affiliation": "Y",
            "affiliationName": "Eye Centers Of America, LLC",
            "address_1": "70 Ridge Rd",
            "city": "North Arlington",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070316318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in North Arlington, NJ

Sources for this page

Verify at the official NPI Registry.