Active NPI
Albert E Grosso, OD
- Optometrist
- Edison, NJ
National Provider Identifier
1609939537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5058
- Practice address
- 940 Amboy Ave
Edison, NJ 08837-2811 - Phone
- (732) 738-1666
- Fax
- (732) 738-8132
- NPI assigned
- Dec 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 5058 | NJ | Primary |
Addresses
Primary practice location
940 Amboy Ave
Edison, NJ 08837-2811
Mailing address
940 Amboy Ave
Edison, NJ 08837-2811
Phone (732) 738-1666
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5655609 | Medicaid | NJ |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5058 | NJ | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301961600000",
"number": "1609939537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "940 AMBOY AVE",
"city": "EDISON",
"state": "NJ",
"postal_code": "088372811",
"telephone_number": "732-738-1666",
"fax_number": "732-738-8132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "940 AMBOY AVE",
"city": "EDISON",
"state": "NJ",
"postal_code": "088372811",
"telephone_number": "732-738-1666",
"fax_number": "732-738-8132"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSSO",
"first_name": "ALBERT",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-19",
"last_updated": "2011-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NJ",
"license": "5058",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5655609",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Edison, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.