Individual provider Active NPI

Diego Xavier Morillo, OD

  • Optometrist
  • Newark, NJ
National Provider Identifier
1811059785
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00566203 Issued in NJ
Practice address
875 Broad St
Newark, NJ 07102-2622
Phone
(973) 622-4492
Fax
(973) 622-5919
NPI assigned
Dec 15, 2006
Last updated
Apr 10, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OA00566203 NJ Primary

Addresses

Primary practice location

875 Broad St
Newark, NJ 07102-2622

Mailing address

1386 Alps Rd
Wayne, NJ 07470-3604
Phone (973) 872-6650

Other identifiers 5

IdentifierTypeStateIssuer
52588OtherNJDAVIS VISION INSURANCE
OP1793OtherNJEYEMED INSURANCE
8277508MedicaidNJ
2428558OtherNJAETNA
29726OtherNJSPECTERA INSURANCE

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
I20040630000406 NJ Practitioner - Optometry 7719964519 Reassigns benefits to 1 organization
Practice locations: Wayne, NJ; Union City, NJ; Newark, NJ; Passaic, NJ

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Centers of America LLCGroup PAC ID 7315125184, 127 clinicians

Practice addresses (Care Compare)

1255 Broad St
Suite 104
Bloomfield, NJ 07003-3061
Phone (973) 707-5632

17 Academy St
Suite 1
Newark, NJ 07102-2923
Phone (973) 624-2090

23 Howe Ave
Passaic, NJ 07055-4001
Phone (973) 777-7600

418 38TH St
Suite 1
Union City, NJ 07087-4999
Phone (201) 867-0199

57 Main St
Hackensack, NJ 07601-7001
Phone (201) 242-8785

89 N Maple Ave
Suite 5
Ridgewood, NJ 07450-3235
Phone (201) 445-1991

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as group
Quality
96.31
Promoting interoperability
100
Improvement activities
40
Cost
73.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OA00566203NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Centers of America, LLC CurrentSince Aug 3, 2020 Accepting new patients
Gail M Blumenthal OD PA Optometrist Past Accepting new patients
Morillo Eye Care Optometrist PastSince Jan 1, 1990 Accepting new patients
Theresa Radtke, OD LLC Optometrist PastSince Jul 31, 2017 Accepting new patients
Independent Therapeutic Doctors of Optometry Optometrist PastSince Jan 1, 1990 Accepting new patients
Clear Vision Optical, Inc. Past Accepting new patients
Morillo Eye Associates Union City Past Accepting new patients
H&C Infinite Vision LLC Optometrist Past Accepting new patients
Yvonne Morillo Optometrist Past Accepting new patients

Locations

108 Broughton Ave
Bloomfield, NJ 07003
Phone (973) 743-1331

1255 Broad St
Ste 104
Bloomfield, NJ 07003
Phone (973) 707-5632

57 Main St
Hackensack, NJ 07601
Phone (201) 242-8785

17 Academy St
Newark, NJ 07102
Phone (973) 624-2090

23 Howe Ave
Passaic, NJ 07055
Phone (973) 777-7600

23 Howe Ave
#1
Passaic, NJ 07055
Phone (973) 777-7600

Organizations & group practices 10

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": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1811059785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1386 ALPS RD",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074703604",
            "telephone_number": "973-872-6650",
            "fax_number": "201-712-9838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 BROAD ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071022622",
            "telephone_number": "973-622-4492",
            "fax_number": "973-622-5919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORILLO",
        "first_name": "DIEGO",
        "middle_name": "XAVIER",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00566203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION INSURANCE",
            "identifier": "52588",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED INSURANCE",
            "identifier": "OP1793",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8277508",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2428558",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA INSURANCE",
            "identifier": "29726",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.