Individual provider Active NPI

Diane L. Fabery, O.D.

  • Optometrist
  • Sparta, NJ
National Provider Identifier
1619957594
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OAO005365 Issued in NJ
Practice address
270 Sparta Ave
Suite 206
Sparta, NJ 07871-1122
Phone
(973) 729-9199
NPI assigned
Jan 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OAO005365 NJ Primary

Addresses

Primary practice location

270 Sparta Ave
Suite 206
Sparta, NJ 07871-1122

Mailing address

270 Sparta Ave
Suite 206
Sparta, NJ 07871-1122
Phone (973) 729-9199

Other identifiers 1

IdentifierTypeStateIssuer
7166702MedicaidNJ

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
I20100326000675 NJ Practitioner - Optometry 1951437151 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Optometry Group PAGroup PAC ID 0648296418, 5 clinicians

Practice addresses (Care Compare)

145 Route 183
Stanhope, NJ 07874
Phone (973) 347-8877

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OAO005365NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Optometry Group, P.a. Optometrist CurrentSince Oct 19, 1995 Accepting new patients
Northwest Optometry Group, P.a. Optometrist CurrentSince Oct 19, 1995 Accepting new patients

Locations

174 State Route 94
Blairstown, NJ 07825
Phone (908) 362-8257

200 US Highway 206
Branchville, NJ 07826
Phone (973) 948-7272

117 Sparta Ave
Sparta, NJ 07871
Phone (973) 726-0669

270 Sparta Ave
Ste 206
Sparta, NJ 07871
Phone (201) 729-9199

145 State Route 183
Stanhope, NJ 07874
Phone (973) 347-8877

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": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1619957594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 SPARTA AVE",
            "address_2": "SUITE 206",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078711122",
            "telephone_number": "973-729-9199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 SPARTA AVE",
            "address_2": "SUITE 206",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078711122",
            "telephone_number": "973-729-9199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABERY",
        "first_name": "DIANE",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "OAO005365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7166702",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparta, NJ

Sources for this page

Verify at the official NPI Registry.