Individual provider Active NPI

Ligaya Prystowsky, M.D.

  • Ophthalmology Physician
  • Nutley, NJ
National Provider Identifier
1821071754
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
25MA04185000 Issued in NJ
Practice address
665 Franklin Ave
Nutley, NJ 07110-1209
Phone
(973) 667-4008
Fax
(973) 667-1655
NPI assigned
Nov 23, 2005
Last updated
Oct 11, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 25MA04185000 NJ Primary

Addresses

Primary practice location

665 Franklin Ave
Nutley, NJ 07110-1209

Mailing address

665 Franklin Ave
Nutley, NJ 07110-1209
Phone (973) 667-4008

Other identifiers 1

IdentifierTypeStateIssuer
1582003MedicaidNJ

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050124000107 NJ Practitioner - Ophthalmology 9739138439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

665 Franklin Ave
Nutley, NJ 07110-1209
Phone (201) 650-5055

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.83 of 100Reported as individual
Quality
92.12
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery64

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA04185000NJMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Omega Medical Group, P.C. Ophthalmology CurrentSince Sep 27, 2017 Accepting new patients

Locations

633 Franklin Ave
Nutley, NJ 07110

665 Franklin Ave
Nutley, NJ 07110
Phone (201) 650-5055

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192060800000",
    "number": "1821071754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 FRANKLIN AVE",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071101209",
            "telephone_number": "973-667-4008",
            "fax_number": "973-667-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 FRANKLIN AVE",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071101209",
            "telephone_number": "973-667-4008",
            "fax_number": "973-667-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRYSTOWSKY",
        "first_name": "LIGAYA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-23",
        "last_updated": "2007-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "25MA04185000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1582003",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nutley, NJ

Sources for this page

Verify at the official NPI Registry.