Individual provider Active NPI

Gary Steven Edelstein, O.D.

  • Optometrist
  • Maple Shade, NJ
National Provider Identifier
1730155987
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00499600 Issued in NJ
Practice address
38 W Main St
Maple Shade, NJ 08052-2432
Phone
(856) 779-7595
Fax
(856) 779-7596
NPI assigned
Feb 27, 2006
Last updated
Aug 27, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OA00499600 NJ Primary

Addresses

Primary practice location

38 W Main St
Maple Shade, NJ 08052-2432

Mailing address

38 W Main St
Maple Shade, NJ 08052-2432
Phone (856) 779-7595

Other identifiers 13

IdentifierTypeStateIssuer
3416405OtherNJCIGNA
35237OtherNJDAVIS VISION
132507OtherNJCOLE VISION
NJ84996OtherNJVISION BENEFITS AMERICA
26010OtherNJAMERICHOICE
26010OtherNJSPECTERA
2K1495OtherNJHEALTH NET
0604402MedicaidNJ
5548003OtherNJAETNA
NJ 4996OtherNJEYEMED VISION
014929001OtherNJMDCR DMERC
0402335000OtherNJAMERIHEALTH/KEYSTONE HMO
580720OtherNJBC/BS PA

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
I20101124000221 NJ Practitioner - Optometry 6204048960 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Daniel H Isaac OD PAGroup PAC ID 8325179781, 8 clinicians
Personaleyes Vision Group, LLCGroup PAC ID 5496111650, 2 clinicians

Practice addresses (Care Compare)

2000 Route 38
Cherry Hill, NJ 08002-2100
Phone (856) 665-4111

700 E Clements Bridge Rd
Runnemede, NJ 08078-1455
Phone (856) 939-8000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NJ 4996NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel H. Isaac, O.D., P.a. CurrentSince Mar 7, 2025 Accepting new patients
Medford Eyewear Center, Inc. Optometrist CurrentSince Dec 1, 2004 Accepting new patients
Personaleyes Vision Group LLC Optometrist CurrentSince Jul 1, 2025 Accepting new patients

Locations

2000 Route 38
Cherry Hill, NJ 08002
Phone (856) 665-4111

200 Tuckerton Rd
Ste 2
Medford, NJ 08055
Phone (856) 983-8887

200 Tuckerton Rd
Medford, NJ 08055
Phone (856) 347-3464

200 Tuckerton Rd
Ste 3
Medford, NJ 08055
Phone (856) 983-8887

700 E Clements Bridge Rd
Runnemede, NJ 08078
Phone (856) 939-5515

3070 Bristol Pike
Ste 2-220
Bensalem, PA 19020
Phone 2144971001108

Organizations & group practices 4

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": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1730155987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 W MAIN ST",
            "city": "MAPLE SHADE",
            "state": "NJ",
            "postal_code": "080522432",
            "telephone_number": "856-779-7595",
            "fax_number": "856-779-7596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 W MAIN ST",
            "city": "MAPLE SHADE",
            "state": "NJ",
            "postal_code": "080522432",
            "telephone_number": "856-779-7595",
            "fax_number": "856-779-7596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDELSTEIN",
        "first_name": "GARY",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00499600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3416405",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "35237",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLE VISION",
            "identifier": "132507",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VISION BENEFITS AMERICA",
            "identifier": "NJ84996",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "26010",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "26010",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "2K1495",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0604402",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5548003",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED VISION",
            "identifier": "NJ 4996",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDCR  DMERC",
            "identifier": "014929001",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH/KEYSTONE HMO",
            "identifier": "0402335000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PA",
            "identifier": "580720",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Shade, NJ

Sources for this page

Verify at the official NPI Registry.