Organization Active NPI

Union City Vision Care PC

  • Optometrist
  • Union City, NJ
National Provider Identifier
1659869675
Registry record updated Apr 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00614201 Issued in NJ
Legal business name
UNION CITY VISION CARE PC
Practice address
3907 Bergenline Ave
Union City, NJ 07087-4819
Phone
(201) 866-2020
Fax
(201) 865-0123
NPI assigned
Apr 25, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2018

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

Authorized official

Name
Dr. Jessica Choi-Lee, ODNPI 1841470713
Title
OD
Phone
(201) 916-9224

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 27OA00614201 NJ Primary

Addresses

Primary practice location

3907 Bergenline Ave
Union City, NJ 07087-4819

Mailing address

3907 Bergenline Ave
Union City, NJ 07087-4819
Phone (201) 866-2020

Other identifiers 1

IdentifierTypeStateIssuer
0287148MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180821001284 NJ Part B Supplier - Clinic/Group Practice 3779832910 Receives reassigned benefits from 1 practitioner
Practice locations: Union City, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1524614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524614400000",
    "number": "1659869675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3907 BERGENLINE AVE",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070874819",
            "telephone_number": "201-866-2020",
            "fax_number": "201-865-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3907 BERGENLINE AVE",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070874819",
            "telephone_number": "201-866-2020",
            "fax_number": "201-865-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNION CITY VISION CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-25",
        "last_updated": "2018-04-25",
        "status": "A",
        "authorized_official_last_name": "CHOI-LEE",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OD",
        "authorized_official_telephone_number": "201-916-9224",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00614201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0287148",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.