Premier Eye Medford LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

PREMIER EYE MEDFORD LLC

Doing business as

Premier Eye Associates

Practice address

200 Tuckerton Rd Ste 6
Medford, NJ 08055-8806

Phone

(856) 983-8887

Fax

(856) 983-4757

NPI assigned

Jun 14, 2023

Last updated

Jan 18, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Jamie Brant

Title

Revenue Cycle Manager

Phone

(856) 688-9093

Specialties & licenses 1

Addresses

Other names 1

• Premier Eye Associates Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tyler John Michael Mills, O.D.

  • Optometrist
  • Collingswood, NJ
  • NPI 1194012633
  Medicare reassignment Care Compare group NPD
• Lauren Kitzhoffer Mullen, O.D.

  • Optometrist
  • Iselin, NJ
  • NPI 1972769040
  Medicare reassignment Care Compare group NPD
• Brian C Samartino, OD

  • Optometrist
  • Collingswood, NJ
  • NPI 1225312879
  Medicare reassignment Care Compare group NPD
• Anthony Starr, OD

  • Optometrist
  • Marlton, NJ
  • NPI 1396435657
  Medicare reassignment Care Compare group NPD
• Elaina Nellis, OD

  • Optometrist
  • New Paltz, NY
  • NPI 1639664154

  NJ

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705536000000",
    "number": "1639853062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 HADDON AVE",
            "city": "COLLINGSWOOD",
            "state": "NJ",
            "postal_code": "081081445",
            "telephone_number": "856-858-3937",
            "fax_number": "856-858-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 TUCKERTON RD STE 6",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080558806",
            "telephone_number": "856-983-8887",
            "fax_number": "856-983-4757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER EYE MEDFORD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-14",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A",
        "authorized_official_last_name": "BRANT",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "856-688-9093",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Eye Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Premier Eye Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ashley Podheiser, MS, CCC-SLP
• Abhilasha Rao Ponnamaneni, M.D.
• Positive Pathways Behavior Services
• Robin P. Potestio, PA-C
• Precision Eye Physcians and Surgeons
• Premier Spine and Wellness Inc
• Paula Preston, APN
• Dominique Price
• Pride Ventures, Inc.
• PRN Surgical Assistance

• Optometrist in Medford, NJ
• Providers in Medford, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.