Individual provider Active NPI

Sunny Mukul Raithatha

  • Optometrist
  • Jersey City, NJ
National Provider Identifier
1679240329
Registry record updated Aug 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
009437 Issued in NY
Practice address
461 Central Ave
Jersey City, NJ 07307-2740
Phone
(201) 420-0101
NPI assigned
Aug 29, 2021
Last updated
Aug 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 009437 NY Primary

Addresses

Primary practice location

461 Central Ave
Jersey City, NJ 07307-2740

Mailing address

59 Magnolia Ave
Jersey City, NJ 07306-1813
Phone (201) 724-2227

Other names 1

  • Dr. Sunny Rai Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220526001792 NJ Practitioner - Optometry 0042698425 Reassigns benefits to 2 organizations
I20241202002870 NY Practitioner - Optometry 0042698425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

461 Central Ave
Suite a
Jersey City, NJ 07307-2740
Phone (201) 420-0101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Super Vision LLC Optometrist CurrentSince May 12, 2023 Accepting new patients
Metros Eye Care Optometry, P.C. Optometrist CurrentSince Oct 1, 2024 Accepting new patients
Vision World Prof Corp Optometrist CurrentSince Jun 1, 2023 Accepting new patients
Optical World of Elizabeth LLC Optometrist PastSince Jun 1, 2023 Accepting new patients

Locations

206 Broad St
Elizabeth, NJ 07201
Phone (908) 629-0011

461 Central Ave
Jersey City, NJ 07307
Phone (201) 420-0101

461 Central Ave
Ste A
Jersey City, NJ 07307
Phone (201) 420-0101

2274 3rd Ave
New York, NY 10035
Phone (212) 722-4453

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1630195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630195200000",
    "number": "1679240329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 MAGNOLIA AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073061813",
            "telephone_number": "201-724-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 CENTRAL AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073072740",
            "telephone_number": "201-420-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAITHATHA",
        "first_name": "SUNNY",
        "middle_name": "MUKUL",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-29",
        "last_updated": "2021-08-29",
        "certification_date": "2021-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "009437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUNNY",
            "last_name": "RAI",
            "prefix": "DR.",
            "credential": "O.D",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.