Active NPI
Anthony Mongiello Jr.
- Optician
- Plainfield, NJ
National Provider Identifier
1790441129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- TD1382
- Practice address
- 160 E 2ND St
Suite B
Plainfield, NJ 07060-1214 - Phone
- (732) 804-5756
- NPI assigned
- Nov 10, 2021
- Last updated
- Mar 13, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | TD1382 | NJ | Primary |
Addresses
Primary practice location
160 E 2ND St
Suite B
Plainfield, NJ 07060-1214
Mailing address
160 E 2ND St
Suite B
Plainfield, NJ 07060-1214
Phone (732) 804-5756
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 160244 | Medicaid | NJ |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | pc | ||
| Other URL | desktop | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TD1382 | NJ | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710288000000",
"number": "1790441129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "160 E 2ND ST",
"address_2": "SUITE B",
"city": "PLAINFIELD",
"state": "NJ",
"postal_code": "070601214",
"telephone_number": "732-804-5756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 E 2ND ST",
"address_2": "SUITE B",
"city": "PLAINFIELD",
"state": "NJ",
"postal_code": "070601214",
"telephone_number": "732-804-5756"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONGIELLO",
"first_name": "ANTHONY",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-11-10",
"last_updated": "2024-03-13",
"certification_date": "2024-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NJ",
"license": "TD1382",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "160244",
"state": "NJ"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "pc",
"affiliation": "N",
"address_1": "160 E 2nd St",
"city": "Plainfield",
"state": "NJ",
"country_code": "US",
"postal_code": "070601214",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "desktop",
"affiliation": "N",
"endpointDescription": "desktop",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "160 E 2nd St",
"city": "Plainfield",
"state": "NJ",
"country_code": "US",
"postal_code": "070601214",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Plainfield, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.