Individual provider Active NPI

Karina Klyatis Puleo

  • Optometrist
  • West Orange, NJ
National Provider Identifier
1730733882
Registry record updated Jul 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00690000 Issued in NJ
Practice address
101 Old Short Hills Rd Ste 430
West Orange, NJ 07052-1023
Phone
(973) 325-3300
NPI assigned
Jul 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 270OA00690000 NJ
Optometrist 152W00000X 27OA00690000 NJ Primary

Addresses

Primary practice location

101 Old Short Hills Rd Ste 430
West Orange, NJ 07052-1023

Mailing address

300 Winston Dr Apt 2414
Cliffside Park, NJ 07010-3228

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
I20190906002976 NJ Practitioner - Optometry 6406185016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NJ Eye and Ear, LLCGroup PAC ID 6002174737, 28 clinicians

Practice addresses (Care Compare)

1016 Main Ave
Clifton, NJ 07011-2327
Phone (973) 546-5700

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as group
Quality
83.97
Promoting interoperability
100
Improvement activities
40
Cost
82.06

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
270OA00690000NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
NJ Eye and Ear LLC CurrentSince Mar 6, 2024 Accepting new patients
Clifton Eye Care LLC Past Accepting new patients

Locations

1016 Main Ave
Unit 1
Clifton, NJ 07011
Phone (973) 546-5700

1016 Main Ave
Clifton, NJ 07011
Phone (973) 546-5700

23 W Palisade Ave
Englewood, NJ 07631
Phone (201) 408-4441

Organizations & group practices 2

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": "1564185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564185600000",
    "number": "1730733882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 WINSTON DR APT 2414",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070103228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 OLD SHORT HILLS RD STE 430",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521023",
            "telephone_number": "973-325-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULEO",
        "first_name": "KARINA",
        "middle_name": "KLYATIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-27",
        "last_updated": "2019-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "270OA00690000",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00690000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

Verify at the official NPI Registry.