Montclair Family Eyecare

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MONTCLAIR FAMILY EYECARE

Practice address

547 Valley Rd
Montclair, NJ 07043-1880

Phone

(973) 783-6446

Fax

(973) 783-6448

NPI assigned

Apr 15, 2024

Last updated

Apr 15, 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

Andrea Antonelli, ODNPI 1902110455

Title

Authorized Official/OD

Phone

(770) 356-0692

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 1

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.

• Andrea B. Antonelli, O.D.

  • Optometrist
  • Montclair, NJ
  • NPI 1902110455
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1713139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713139200000",
    "number": "1669226767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "547 VALLEY RD",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070431880",
            "telephone_number": "973-783-6446",
            "fax_number": "973-783-6448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "547 VALLEY RD",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070431880",
            "telephone_number": "973-783-6446",
            "fax_number": "973-783-6448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTCLAIR FAMILY EYECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-15",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A",
        "authorized_official_last_name": "ANTONELLI",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL/OD",
        "authorized_official_telephone_number": "770-356-0692",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Montclair Counseling Center
• Montclair Dental Spa
• Montclair Digital Dental
• Montclair Emergency Physicians LLC
• Montclair Endocrine Associates
• Montclair Foot and Ankle (NJ Ankle Pain)
• Montclair Hospital LLC (Montclair Multi Speciality Health Center)
• Montclair Hospital LLC (ESRD Facility)
• Montclair Hospital LLC (Outpatient Behavioral Health Department)
• Montclair Hospital LLC (Tcu)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; 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.