Omega Medical Group, P.C.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

MA041850 Issued in NJ

Legal business name

OMEGA MEDICAL GROUP, P.C.

Practice address

665 Franklin Ave
Nutley, NJ 07110-1209

Phone

(973) 667-4008

NPI assigned

Dec 15, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Ligaya Prystowsky, MDNPI 1821071754

Title

President

Phone

(973) 667-4008

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

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

• Ligaya Prystowsky, M.D.

  • Ophthalmology Physician
  • Nutley, NJ
  • NPI 1821071754
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1229299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229299200000",
    "number": "1720223084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 FRANKLIN AVE",
            "address_2": "PMB 133",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071101209",
            "telephone_number": "973-667-4008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 FRANKLIN AVE",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071101209",
            "telephone_number": "973-667-4008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMEGA MEDICAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-15",
        "last_updated": "2008-12-15",
        "status": "A",
        "authorized_official_last_name": "PRYSTOWSKY",
        "authorized_official_first_name": "LIGAYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-667-4008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "MA041850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1582003",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Maria A. Ongoco-Kamhi, MS, CRC, LAC
• Oral & Maxillofacial Assoc of Nutley
• Oral and Maxillofacial Assoc of Nutley

• Ophthalmology Physician in Nutley, NJ
• Providers in Nutley, NJ by specialty
• Ophthalmology Physician in New Jersey

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