Individual provider Active NPI

Magdalena Spiewak, O.D.

  • Optometrist
  • Jamesburg, NJ
National Provider Identifier
1760797039
Registry record updated Dec 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00638001 Issued in NJ
Practice address
333 Forsgate Dr
Unit 6
Jamesburg, NJ 08831-1567
Phone
(732) 656-1515
NPI assigned
Aug 11, 2010
Last updated
Dec 1, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 007480-1 NY
Optometrist 152W00000X 27OA00638001 NJ Primary

Addresses

Primary practice location

333 Forsgate Dr
Unit 6
Jamesburg, NJ 08831-1567

Mailing address

333 Forsgate Dr
Unit 6
Jamesburg, NJ 08831-1567
Phone (732) 656-1515

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
I20120802000504 NJ Practitioner - Optometry 1153508114 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4 Cornwall Dr
Suite 201
East Brunswick, NJ 08816-3332
Phone (732) 656-1515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
27OA00638001NJMDOptometrist
007480-1NYMDOptometrist
007480NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Brunswick Vision Care LLC Optometrist CurrentSince Aug 1, 2012 Accepting new patients
Bensonhurst Family Vision Corp. Optometrist PastSince Jan 1, 1999 Accepting new patients
Bensonhurst Family Vision Corp. Past Accepting new patients

Locations

333 Forsgate Dr
#6
Jamesburg, NJ 08831
Phone (347) 306-0561

333 Forsgate Dr
Unit 6
Jamesburg, NJ 08831
Phone (732) 656-1515

Organizations & group practices 3

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": "1281484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480550400000",
    "number": "1760797039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 FORSGATE DR",
            "address_2": "UNIT 6",
            "city": "JAMESBURG",
            "state": "NJ",
            "postal_code": "088311567",
            "telephone_number": "732-656-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 FORSGATE DR",
            "address_2": "UNIT 6",
            "city": "JAMESBURG",
            "state": "NJ",
            "postal_code": "088311567",
            "telephone_number": "732-656-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIEWAK",
        "first_name": "MAGDALENA",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-11",
        "last_updated": "2016-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "007480-1",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00638001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamesburg, NJ

Sources for this page

Verify at the official NPI Registry.