Individual provider Active NPI

Nieves M Fernandez, O.D.

  • Optometrist
  • North Bergen, NJ
National Provider Identifier
1740331826
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OA004255 Issued in NJ
Practice address
7225 Bergenline Ave
North Bergen, NJ 07047-5497
Phone
(201) 861-8813
Fax
(201) 861-2695
NPI assigned
Jan 15, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OA004255 NJ Primary

Addresses

Primary practice location

7225 Bergenline Ave
North Bergen, NJ 07047-5497

Mailing address

7225 Bergenline Ave
North Bergen, NJ 07047-5497
Phone (201) 861-8813

Other identifiers 2

IdentifierTypeStateIssuer
0511989OtherNJAETNA
P408457OtherNJOXFORD HEALTH

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
I20120119000568 NJ Practitioner - Optometry 4880861616 Practice locations: North Bergen, NJ

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7225 Bergenline Ave
North Bergen, NJ 07047-5497
Phone (201) 861-8813

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Luis E Vazquez MD LLC PastSince Aug 23, 2009 Accepting new patients
3 Dimension Diagnostic Solutions Past Accepting new patients

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, 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": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740331826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7225 BERGENLINE AVE",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070475497",
            "telephone_number": "201-861-8813",
            "fax_number": "201-861-2695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7225 BERGENLINE AVE",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070475497",
            "telephone_number": "201-861-8813",
            "fax_number": "201-861-2695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "NIEVES",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "OA004255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0511989",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH",
            "identifier": "P408457",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bergen, NJ

Sources for this page

Verify at the official NPI Registry.