Individual provider Active NPI

Angelo J. Aiello, O.D.

  • Optometrist
  • Mount Laurel, NJ
National Provider Identifier
1780734384
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
NJ3940 Issued in NJ
Practice address
689 Lincoln Dr
Mount Laurel, NJ 08054-3227
Phone
(856) 905-9852
NPI assigned
Jan 12, 2007
Last updated
Sep 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NJ3940 NJ Primary

Addresses

Primary practice location

689 Lincoln Dr
Mount Laurel, NJ 08054-3227

Mailing address

689 Lincoln Dr
Mount Laurel, NJ 08054-3227
Phone (856) 231-7719

Other identifiers 2

IdentifierTypeStateIssuer
1126806MedicaidNJ
521447C0ZOtherNJMEDICARE

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
I20120404000840 NJ Practitioner - Optometry 6608770466 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1978
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

320 Beverly Rancocas Rd
Suite 2E
Willingboro, NJ 08046-3428
Phone (609) 877-1229

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NJ3940NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Clarity Optics Inc. Optometrist CurrentSince Sep 7, 2024 Accepting new patients
Dr. Angelo J. Aiello Optometrist CurrentSince Jun 1, 2002 Accepting new patients
Millis Eye Associates, LLC Optometrist PastSince Jan 1, 2007 Accepting new patients

Locations

2910 Route 130
Delran, NJ 08075
Phone (856) 461-0987

2910 Route 130
Ste 2
Delran, NJ 08075
Phone (856) 461-0987

320 Beverly Rancocas Rd
Ste 2E
Willingboro, NJ 08046
Phone (609) 877-1229

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1780734384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "689 LINCOLN DR",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080543227",
            "telephone_number": "856-231-7719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "689 LINCOLN DR",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080543227",
            "telephone_number": "856-905-9852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AIELLO",
        "first_name": "ANGELO",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "NJ3940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1126806",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "521447C0Z",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

Verify at the official NPI Registry.