Ez.MD.Optical LLC

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

31TD00351400 Issued in NJ

Legal business name

EZ.MD.OPTICAL LLC

Practice address

3196 Kennedy Blvd Ste 2
Union City, NJ 07087-2468

Phone

(201) 628-1465

NPI assigned

Jul 19, 2016

Organization subpart

Yes

Parent organization

EZ MD OPTICALAs reported in NPPES

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

Authorized official

Name

Mr. Roger R Romero Sr., 31TD00351400NPI 1780973834

Title

Lic Ophthalmic Dispenser Optician

Phone

(201) 628-1465

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ez md optical Former legal business name

Practitioners 1

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

• Roger R Romero Sr., LICENSED OPTICIAN

  • Ophthalmic Technician/Technologist
  • Union City, NJ
  • NPI 1780973834
  NPD Authorized official

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468886400000",
    "number": "1760835375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3196 KENNEDY BLVD STE 2",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070872468",
            "telephone_number": "201-628-1465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3196 KENNEDY BLVD STE 2",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070872468",
            "telephone_number": "201-628-1465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EZ.MD.OPTICAL LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EZ MD OPTICAL",
        "enumeration_date": "2016-07-19",
        "last_updated": "2016-07-19",
        "status": "A",
        "authorized_official_last_name": "ROMERO",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "LIC OPHTHALMIC DISPENSER OPTICIAN",
        "authorized_official_telephone_number": "201-628-1465",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "31TD00351400"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NJ",
            "license": "31TD00351400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0304026",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ez md optical",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Health Maintenance Organization in Union City, NJ
• Providers in Union City, NJ by specialty
• Health Maintenance Organization in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.