NPIMap

Organization Active NPI

Alessandra Bertolucci MD LLC

Doing business as Associated Eye Physicans

  • Ophthalmology Physician
  • Clifton, NJ
National Provider Identifier
1568617330
Registry record updated Nov 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
25MA07279200 Issued in NJ
Legal business name
ALESSANDRA BERTOLUCCI MD LLC
Doing business as
Associated Eye Physicans
Practice address
1033 Clifton Ave Ste 107
Clifton, NJ 07013-3517
Phone
(973) 472-6405
Fax
(973) 472-6406
NPI assigned
Nov 20, 2008
Last updated
Nov 22, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2019

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

Authorized official

Name
Alessandra Bertolucci, MDNPI 1174528996
Title
Doctor
Phone
(973) 472-6405

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
Ophthalmology Physician 207W00000X 25MA07279200 NJ Primary

Addresses

Primary practice location

1033 Clifton Ave Ste 107
Clifton, NJ 07013-3517

Mailing address

1033 Clifton Ave Ste 107
Clifton, NJ 07013-3517
Phone (973) 773-9882

Other practice location 1

505 Wanaque Ave
Pompton Lakes, NJ 07442-1849
Phone (973) 835-1222

Other practice location 2

263 Lafayette St
Newark, NJ 07105-7600
Phone (973) 589-0104

Other practice location 3

240 Williamson ST
5th Fl STE 505
Elizabeth, NJ 07202-3674
Phone (908) 355-0478

Other practice location 4

138 S Euclid Ave
Westfield, NJ 07090-2130
Phone (908) 232-0909

Other names 1

  • Associated Eye Physicans Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090224000590 NJ Part B Supplier - Clinic/Group Practice 6709941859 Receives reassigned benefits from 8 practitioners
Practice locations: Clifton, NJ; East Orange, NJ; Elizabeth, NJ; Newark, NJ; Pompton Lakes, NJ; Roselle, NJ; Westfield, NJ
O20191121002695 NJ DME Supplier - Optician 6709941859 Practice locations: Clifton, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Alessandra Bertolucci MD LLC1033 Clifton Ave, Clifton, NJ 07013-3517(973) 472-6405 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Dec 15, 2008

National Provider Directory

National Provider Directory

Locations

1033 Clifton Ave
Ste 107
Clifton, NJ 07013
Phone (973) 472-6405

1135 Clifton Ave
Ste 105
Clifton, NJ 07013
Phone (973) 773-9882

263 Lafayette St
Newark, NJ 07105
Phone (973) 589-0104

505 Wanaque Ave
Pompton Lakes, NJ 07442
Phone (973) 616-0666

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1227139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574380800000",
    "number": "1568617330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 CLIFTON AVE STE 107",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070133517",
            "telephone_number": "973-773-9882",
            "fax_number": "973-773-9883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 CLIFTON AVE STE 107",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070133517",
            "telephone_number": "973-472-6405",
            "fax_number": "973-472-6406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 Wanaque Ave",
            "address_purpose": "LOCATION",
            "city": "Pompton Lakes",
            "state": "NJ",
            "postal_code": "074421849",
            "country_code": "US",
            "telephone_number": "973-835-1222",
            "fax_number": "973-616-0666",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "263 Lafayette St",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071057600",
            "country_code": "US",
            "telephone_number": "973-589-0104",
            "fax_number": "973-589-5084",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "240 Williamson ST",
            "address_2": "5th Fl STE 505",
            "address_purpose": "LOCATION",
            "city": "Elizabeth",
            "state": "NJ",
            "postal_code": "072023674",
            "country_code": "US",
            "telephone_number": "908-355-0478",
            "fax_number": "908-365-0001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "138 S Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Westfield",
            "state": "NJ",
            "postal_code": "070902130",
            "country_code": "US",
            "telephone_number": "908-232-0909",
            "fax_number": "908-232-4339",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ALESSANDRA BERTOLUCCI MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-20",
        "last_updated": "2019-11-22",
        "status": "A",
        "authorized_official_last_name": "BERTOLUCCI",
        "authorized_official_first_name": "ALESSANDRA",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "973-472-6405",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "25MA07279200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Associated Eye Physicans",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.