Organization Active NPI

New Jersey Optometry PC

  • Optometrist
  • Somerset, NJ
National Provider Identifier
1730532896
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00632200 Issued in NJ
Legal business name
NEW JERSEY OPTOMETRY PC
Practice address
1075 Easton Ave
Store # 12B
Somerset, NJ 08873-1648
Phone
(732) 214-1600
NPI assigned
Jul 13, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Authorized official

Name
Arthur Vayner, O.D.
Title
Optometrist
Phone
(347) 842-8871

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 27OA00632200 NJ Primary

Addresses

Primary practice location

1075 Easton Ave
Store # 12B
Somerset, NJ 08873-1648

Mailing address

1075 Easton Ave
Store # 12B
Somerset, NJ 08873-1648

Other identifiers 1

IdentifierTypeStateIssuer
0629669MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160929000489 NJ Part B Supplier - Clinic/Group Practice 7214224625 Receives reassigned benefits from 3 practitioners
Practice locations: Somerset, NJ

National Provider Directory

National Provider Directory

Locations

1075 Easton Ave
#12B
Somerset, NJ 08873

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1468368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712880000000",
    "number": "1730532896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 EASTON AVE",
            "address_2": "STORE # 12B",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088731648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 EASTON AVE",
            "address_2": "STORE # 12B",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088731648",
            "telephone_number": "732-214-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW JERSEY OPTOMETRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-13",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A",
        "authorized_official_last_name": "VAYNER",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "347-842-8871",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00632200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0629669",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; 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.