Individual provider Active NPI

Madeline Fernandez, O.D.

  • Optometrist
  • Westfield, NJ
National Provider Identifier
1639215718
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5245/00516 Issued in NJ
Practice address
253 E Broad St
Westfield, NJ 07090-2119
Phone
(908) 389-0390
Fax
(908) 389-0394
NPI assigned
Jan 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5245 NJ
Optometrist 152W00000X 00516 NJ
Optometrist 152W00000X 5245/00516 NJ Primary

Addresses

Primary practice location

253 E Broad St
Westfield, NJ 07090-2119

Mailing address

253 E Broad St
Westfield, NJ 07090-2119
Phone (908) 389-0390

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
I20050801000170 NJ Practitioner - Optometry 7416985460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
I to Eye IncGroup PAC ID 5991957177, 2 clinicians

Practice addresses (Care Compare)

253 E Broad St
Westfield, NJ 07090-2119
Phone (908) 389-0390

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00516NJMDOptometrist
5245NJMDOptometrist
5245/00516NJMDOptometrist

Organizations & group practices 1

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1639215718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 E BROAD ST",
            "city": "WESTFIELD",
            "state": "NJ",
            "postal_code": "070902119",
            "telephone_number": "908-389-0390",
            "fax_number": "908-389-0394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "253 E BROAD ST",
            "city": "WESTFIELD",
            "state": "NJ",
            "postal_code": "070902119",
            "telephone_number": "908-389-0390",
            "fax_number": "908-389-0394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "MADELINE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "5245",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "00516",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "5245/00516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westfield, NJ

Sources for this page

Verify at the official NPI Registry.