Individual provider Active NPI

Michael Thomas Montenare, O.D.

  • Optometrist
  • Wyckoff, NJ
National Provider Identifier
1609124296
Registry record updated Jan 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00641300 Issued in NJ
Practice address
541 Cedar Hill Ave Ste H
Wyckoff, NJ 07481-2150
Phone
(631) 455-7123
NPI assigned
Aug 29, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vision Therapy Optometrist 152WV0400X 27OA00641300 NJ
Optometrist 152W00000X 27OA00641300 NJ Primary

Addresses

Primary practice location

541 Cedar Hill Ave Ste H
Wyckoff, NJ 07481-2150

Mailing address

67 Cottage St FL 1
Midland Park, NJ 07432-1953
Phone (631) 455-7123

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
I20130528000671 NJ Practitioner - Optometry 2264670579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

541 Cedar Hill Ave
Suite H
Wyckoff, NJ 07481-2150
Phone (201) 857-5111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OA00641300NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Montenare Eye Care & Vision Therapy LLC Optometrist CurrentSince Feb 1, 2018 Accepting new patients
Visual Performance and Learning Center PC Vision Therapy CurrentSince Apr 18, 2017 Accepting new patients

Locations

17-10 Fair Lawn Ave
Fl 2
Fair Lawn, NJ 07410
Phone (201) 794-7977

541 Cedar Hill Ave
Wyckoff, NJ 07481
Phone (201) 447-6262

541 Cedar Hill Ave
Ste H
Wyckoff, NJ 07481
Phone (201) 857-5111

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514937600000",
    "number": "1609124296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 COTTAGE ST FL 1",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "074321953",
            "telephone_number": "631-455-7123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 CEDAR HILL AVE STE H",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074812150",
            "telephone_number": "631-455-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTENARE",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-29",
        "last_updated": "2018-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "NJ",
            "license": "27OA00641300",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00641300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyckoff, NJ

Sources for this page

Verify at the official NPI Registry.