Organization Active NPI

Old Bridge Vision Inc

  • Optometrist
  • Parlin, NJ
National Provider Identifier
1508160201
Registry record updated Jun 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
OLD BRIDGE VISION INC
Practice address
1040 US Highway 9
Parlin, NJ 08859-1401
Phone
(732) 727-1811
Fax
(732) 727-6399
NPI assigned
Jan 10, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2013

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

Authorized official

Name
Dr. Robert J GreenbergNPI 1740343573
Title
President
Phone
(732) 727-1811

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1040 US Highway 9
Parlin, NJ 08859-1401

Mailing address

1040 US Highway 9
Parlin, NJ 08859-1401
Phone (732) 727-1811

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110315000230 NJ Part B Supplier - Clinic/Group Practice 0446432355 Receives reassigned benefits from 1 practitioner
Practice locations: Parlin, NJ

National Provider Directory

National Provider Directory

Locations

1040 US Highway 9
Parlin, NJ 08859
Phone (732) 727-1811

Practitioners & affiliated clinicians

Practitioners 1

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": "1294617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372118400000",
    "number": "1508160201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 US HIGHWAY 9",
            "city": "PARLIN",
            "state": "NJ",
            "postal_code": "088591401",
            "telephone_number": "732-727-1811",
            "fax_number": "732-727-6399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 US HIGHWAY 9",
            "city": "PARLIN",
            "state": "NJ",
            "postal_code": "088591401",
            "telephone_number": "732-727-1811",
            "fax_number": "732-727-6399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD BRIDGE VISION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-10",
        "last_updated": "2013-06-25",
        "status": "A",
        "authorized_official_last_name": "GREENBERG",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-727-1811",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parlin, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2013; 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.