Individual provider Active NPI

Alan Jay Deyong, O.D.

  • Optometrist
  • Colonia, NJ
National Provider Identifier
1578627162
Registry record updated May 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
270A00375500 Issued in NJ
Practice address
1009 St. Georges Avenue
Colonia, NJ 07067-4049
Phone
(732) 634-8600
Fax
(732) 283-0263
NPI assigned
Dec 20, 2006
Last updated
May 15, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 270A00375500 NJ Primary

Addresses

Primary practice location

1009 St. Georges Avenue
Colonia, NJ 07067-4049

Mailing address

1009 St. Georges Avenue
Colonia, NJ 07067-4049
Phone (732) 634-8600

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120417000267 NJ Practitioner - Optometry 4486759032 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eyexam Group - Totowa, P.a.Group PAC ID 5092772293, 4 clinicians
Eyexam Group P aGroup PAC ID 8325224330, 3 clinicians

Practice addresses (Care Compare)

125 US Hwy 46
Totowa, NJ 07512-2338
Phone (973) 890-7070

712 N State RT
Suite 17
Paramus, NJ 07652-3106
Phone (201) 262-7100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
270A00375500NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Deyong's Eyeworld LLC Optometrist CurrentSince Jan 7, 1991 Accepting new patients
Eyexam Group - Totowa, P.a. Optometrist CurrentSince Feb 1, 1989 Accepting new patients
Eyexam Group P a Optometrist CurrentSince Jan 7, 1991 Accepting new patients
Wayne Epstein PastSince Jan 7, 1991 Accepting new patients

Locations

1009 Saint Georges Ave
Colonia, NJ 07067
Phone (732) 634-8600

1009 Saint Georges Ave
#J
Colonia, NJ 07067

1009 Saint Georges Ave
Ste 4
Colonia, NJ 07067
Phone (732) 634-8600

340 N State Rt 17
Paramus, NJ 07652
Phone (201) 262-7100

712 N State Rt 17
Paramus, NJ 07652
Phone (201) 262-7100

125 US Highway 46
Totowa, NJ 07512
Phone (201) 890-7070

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337040000000",
    "number": "1578627162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 ST. GEORGES AVENUE",
            "city": "COLONIA",
            "state": "NJ",
            "postal_code": "070674049",
            "telephone_number": "732-634-8600",
            "fax_number": "732-283-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 ST. GEORGES AVENUE",
            "city": "COLONIA",
            "state": "NJ",
            "postal_code": "070674049",
            "telephone_number": "732-634-8600",
            "fax_number": "732-283-0263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEYONG",
        "first_name": "ALAN",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2012-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "270A00375500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colonia, NJ

Sources for this page

Verify at the official NPI Registry.