Individual provider Active NPI

Danielle Gaeta, O.D.

  • Optometrist
  • Ledgewood, NJ
National Provider Identifier
1700262466
Registry record updated Aug 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
270A00659700 Issued in NJ
Practice address
410 State Route 10 West
Suite 202
Ledgewood, NJ 07852
Phone
(973) 584-2020
Fax
(973) 584-4992
NPI assigned
Aug 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 270A00659700 NJ Primary

Addresses

Primary practice location

410 State Route 10 West
Suite 202
Ledgewood, NJ 07852

Mailing address

410 State Route 10 West
Suite 202
Ledgewood, NJ 07852
Phone (973) 584-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20151021001684 NJ Practitioner - Optometry 1658680202 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Eyecare Professionals, LLCGroup PAC ID 8426318585, 3 clinicians

Practice addresses (Care Compare)

410 State Route 10
BLDG 202
Ledgewood, NJ 07852-9600
Phone (973) 584-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
270A00659700NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Eyecare Professionals LLC Optometrist CurrentSince Jan 2, 2018 Accepting new patients

Locations

410 State Route 10
Ste 202
Ledgewood, NJ 07852
Phone (973) 584-2020

66 Sunset Strip
Ste 107
Succasunna, NJ 07876
Phone (201) 584-4451

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1438732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438732800000",
    "number": "1700262466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 STATE ROUTE 10 WEST",
            "address_2": "SUITE 202",
            "city": "LEDGEWOOD",
            "state": "NJ",
            "postal_code": "07852",
            "telephone_number": "973-584-2020",
            "fax_number": "973-584-4992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 STATE ROUTE 10 WEST",
            "address_2": "SUITE 202",
            "city": "LEDGEWOOD",
            "state": "NJ",
            "postal_code": "07852",
            "telephone_number": "973-584-2020",
            "fax_number": "973-584-4992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAETA",
        "first_name": "DANIELLE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-05",
        "last_updated": "2015-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "270A00659700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ledgewood, NJ

Sources for this page

Verify at the official NPI Registry.