Individual provider Active NPI

Deanna Z Macek, MD

  • Ophthalmology Physician
  • Wayne, NJ
National Provider Identifier
1508938010
Registry record updated Mar 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MA37859 Issued in NJ
Practice address
2025 Hamburg Tpke
Suite H
Wayne, NJ 07470-6260
Phone
(973) 831-0122
Fax
(973) 616-8402
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2008

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 MA37859 NJ Primary

Addresses

Primary practice location

2025 Hamburg Tpke
Suite H
Wayne, NJ 07470-6260

Mailing address

2025 Hamburg Turnpike
Suite H
Wayne, NJ 07470
Phone (973) 831-0122

Other identifiers 1

IdentifierTypeStateIssuer
3463109MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA37859NJMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204761600000",
    "number": "1508938010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 HAMBURG TURNPIKE",
            "address_2": "SUITE H",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "07470",
            "telephone_number": "973-831-0122",
            "fax_number": "973-616-8402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 HAMBURG TPKE",
            "address_2": "SUITE H",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074706260",
            "telephone_number": "973-831-0122",
            "fax_number": "973-616-8402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACEK",
        "first_name": "DEANNA",
        "middle_name": "Z",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2008-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "MA37859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3463109",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.