Ravine Eye Center Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA00453001 Issued in NJ

Legal business name

RAVINE EYE CENTER INC

Practice address

1722 New Bedford Rd
Wall Township, NJ 07719-3867

Phone

(732) 974-1400

Fax

(732) 974-2121

NPI assigned

May 19, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Shelli L Ravine, ODNPI 1366439077

Title

Vice Pres

Phone

(732) 974-1400

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 8

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

• Shelli Lynn Ravine, O.D.

  • Optometrist
  • Wall Township, NJ
  • NPI 1366439077
  Medicare reassignment NPD Authorized official
• Neal Singh Athwal

  • Optometrist
  • Toms River, NJ
  • NPI 1295222511
  Medicare reassignment NPD
• Linda Tromburg Cox, O.D.

  • Optometrist
  • Wall Township, NJ
  • NPI 1043257454
  Medicare reassignment NPD
• Deborah Ann Popplewell, O.D.

  • Optometrist
  • Toms River, NJ
  • NPI 1497897953
  Medicare reassignment NPD
• Charles L Abady, O.D.

  • Optometrist
  • Oakhurst, NJ
  • NPI 1205817517
  NPD
• Goldie Lisa Greller, O.D.

  • Optometrist
  • Freehold, NJ
  • NPI 1689785933
  NPD
• Anthony Giallombardo Jr., OD

  • Optometrist
  • Wall, NJ
  • NPI 1710501853
  NPD (past)
• Tyler James Lesko, OD

  • Optometrist
  • Wall Township, NJ
  • NPI 1003548538
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210032000000",
    "number": "1700839743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 NEW BEDFORD RD",
            "city": "WALL TOWNSHIP",
            "state": "NJ",
            "postal_code": "077193867",
            "telephone_number": "732-974-1400",
            "fax_number": "732-974-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 NEW BEDFORD RD",
            "city": "WALL TOWNSHIP",
            "state": "NJ",
            "postal_code": "077193867",
            "telephone_number": "732-974-1400",
            "fax_number": "732-974-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVINE EYE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2008-05-06",
        "status": "A",
        "authorized_official_last_name": "RAVINE",
        "authorized_official_first_name": "SHELLI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VICE PRES",
        "authorized_official_telephone_number": "732-974-1400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00453001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "1700839743",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sergei A Pushilin, M.D.
• Rebecca Criswell Quigley
• Nicole Quinn
• Said Ramadan, APN-C
• Cassandra Rampino, LCSW
• Shelli Lynn Ravine, O.D.
• Alicia L. Realmuto, N.P.
• Ma Jeanette Andres Reyes, P.T.
• Gaetano A. Ricciardone, D.C.
• Doreen Ann Riegal, MS

• Optometrist in Wall Township, NJ
• Providers in Wall Township, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; 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.