Active NPI
Debra M. Prieto, M.D.
- Ophthalmology Physician
- Woodbury, NJ
National Provider Identifier
1639175169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 25MA05804500
- Practice address
- 661 N Broad St
Woodbury, NJ 08096-1621 - Phone
- (856) 845-7968
- Fax
- (856) 845-8544
- NPI assigned
- Jun 21, 2005
- Last updated
- Feb 11, 2011
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 25MA05804500 | NJ | Primary |
Addresses
Primary practice location
661 N Broad St
Woodbury, NJ 08096-1621
Mailing address
661 N Broad St
Woodbury, NJ 08096-1621
Phone (856) 845-7968
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5389801 | Medicaid | NJ |
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: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090708000331 | NJ | Practitioner - Ophthalmology | 2668523440 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA05804500 | NJ | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297382400000",
"number": "1639175169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "661 N BROAD ST",
"city": "WOODBURY",
"state": "NJ",
"postal_code": "080961621",
"telephone_number": "856-845-7968",
"fax_number": "856-845-8544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "661 N BROAD ST",
"city": "WOODBURY",
"state": "NJ",
"postal_code": "080961621",
"telephone_number": "856-845-7968",
"fax_number": "856-845-8544"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRIETO",
"first_name": "DEBRA",
"middle_name": "M.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-21",
"last_updated": "2011-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "NJ",
"license": "25MA05804500",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5389801",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Woodbury, NJ
- Premier Foot and Ankle, Inc.
- Premier Orthopaedic of South Jersey
- Premier Women's Health of South Jersey
- Nikita Rashi Pressley-Stokes, NURSE
- Prestige Support Services
- Princeton Professional Care LLC (Home Helpers)
- Professional Pulmonary Service, Inc
- Jordyn Quigley
- Allison Quinn, LAC
- Merrilie Rackham, MERRILIE RACKHAM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.