Organization Active NPI

Bacho Family Eye Care LLC

  • Optometrist
  • Cinnaminson, NJ
National Provider Identifier
1649634049
Registry record updated Apr 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
BACHO FAMILY EYE CARE LLC
Practice address
1104 Route 130 N
Suite T
Cinnaminson, NJ 08077-3032
Phone
(856) 303-1506
Fax
(856) 499-2412
NPI assigned
Apr 12, 2016
Last updated
Apr 12, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2016

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

Authorized official

Name
Dr. Alan James Bacho, O.D.NPI 1235296609
Title
Member
Phone
(609) 790-7196

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1104 Route 130 N
Suite T
Cinnaminson, NJ 08077-3032

Mailing address

PO Box 2362
Cinnaminson, NJ 08077-5362
Phone (856) 303-1506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170109000093 NJ Part B Supplier - Clinic/Group Practice 3375824220 Receives reassigned benefits from 2 practitioners
Practice locations: Cinnaminson, NJ

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2324209Bacho Family Eye Care LLC1104 Route 130 North, Cinnaminson, NJ 08077Certificate of waiverMay 19, 2027

National Provider Directory

National Provider Directory

Locations

1104 Route 130 N
Ste T
Cinnaminson, NJ 08077
Phone (856) 303-1506

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460419200000",
    "number": "1649634049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2362",
            "city": "CINNAMINSON",
            "state": "NJ",
            "postal_code": "080775362",
            "telephone_number": "856-303-1506",
            "fax_number": "856-499-2412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 ROUTE 130 N",
            "address_2": "SUITE T",
            "city": "CINNAMINSON",
            "state": "NJ",
            "postal_code": "080773032",
            "telephone_number": "856-303-1506",
            "fax_number": "856-499-2412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACHO FAMILY EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-12",
        "last_updated": "2016-04-12",
        "status": "A",
        "authorized_official_last_name": "BACHO",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "609-790-7196",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cinnaminson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; 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.