Organization Active NPI

Professional Eyecare Associates PA

  • Optometrist
  • Paramus, NJ
National Provider Identifier
1497865463
Registry record updated Feb 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00467700 Issued in NJ
Legal business name
PROFESSIONAL EYECARE ASSOCIATES PA
Practice address
275 Forest Ave
Suite 115
Paramus, NJ 07652-5426
Phone
(201) 986-0202
Fax
(201) 986-0977
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2010

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

Authorized official

Name
Ms. Nancy Strull
Title
Office Manager
Phone
(201) 986-0202

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 27OA00467700 NJ Primary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 27OA00271700 NJ
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 27OA00605100 NJ
Corneal and Contact Management OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152WC0802X 27OM00022900 NJ
Corneal and Contact Management OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152WC0802X 27OM00026100 NJ
Low Vision Rehabilitation OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152WL0500X 27OM00022900 NJ

Addresses

Primary practice location

275 Forest Ave
Suite 115
Paramus, NJ 07652-5426

Mailing address

275 Forest Ave
Suite 115
Paramus, NJ 07652-5426
Phone (201) 986-0202

Other identifiers 12

IdentifierTypeStateIssuer
01131OtherNJSPECTERA
2849208MedicaidNJ
1K6548OtherNJHEALTHNET
310832OtherNJNVA
908499OtherNJBLOCK VISION
P467376OtherNJOXFORD
60000697OtherNJGHI
1848OtherNJDAVIS VISION
410007420OtherNJRRMCR
28302OtherNJAUSHC
29534OtherNJAMERIGROUP
NJ4677OtherNJEYEMED

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041207000281 NJ Part B Supplier - Clinic/Group Practice 3173589645 Receives reassigned benefits from 8 practitioners
Practice locations: Closter, NJ; Paramus, NJ

National Provider Directory

National Provider Directory

Locations

270 Closter Dock Rd
Closter, NJ 07624
Phone (201) 768-2433

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264982400000",
    "number": "1497865463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 FOREST AVE",
            "address_2": "SUITE 115",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076525426",
            "telephone_number": "201-986-0202",
            "fax_number": "201-986-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 FOREST AVE",
            "address_2": "SUITE 115",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076525426",
            "telephone_number": "201-986-0202",
            "fax_number": "201-986-0977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL EYECARE ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2010-02-01",
        "status": "A",
        "authorized_official_last_name": "STRULL",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "201-986-0202",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00467700",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00271700",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00605100",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NJ",
            "license": "27OM00022900",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NJ",
            "license": "27OM00026100",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "NJ",
            "license": "27OM00022900",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "01131",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2849208",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "1K6548",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NVA",
            "identifier": "310832",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLOCK VISION",
            "identifier": "908499",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P467376",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "60000697",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "1848",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMCR",
            "identifier": "410007420",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AUSHC",
            "identifier": "28302",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "29534",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "NJ4677",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paramus, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2010; 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.