NPIMap

Organization Active NPI

Santamaria Eye Center P a

  • Ophthalmology Physician
  • Edison, NJ
National Provider Identifier
1841425840
Registry record updated Sep 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MA034125 Issued in NJ
Legal business name
SANTAMARIA EYE CENTER P A
Practice address
100 Menlo Park Drive
Suite 408
Edison, NJ 08837
Phone
(732) 826-5159
Fax
(732) 826-2107
NPI assigned
May 19, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2019

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

Authorized official

Name
Miss Mencia Disla
Title
Practice Administrator
Phone
(732) 826-5159

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X MA034125 NJ Primary

Addresses

Primary practice location

100 Menlo Park Drive
Suite 408
Edison, NJ 08837

Mailing address

100 Menlo Park Drive
Suite 408
Edison, NJ 08837
Phone (732) 826-5159

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050603000737 NJ Part B Supplier - Clinic/Group Practice 2961445606 Receives reassigned benefits from 12 practitioners
1 other NPI on this enrollment
Practice locations: Edison, NJ; Perth Amboy, NJ
O20100930096577 NJ DME Supplier - Physician - OphthalmologyDME Supplier - Physician - OptometristDME Supplier - Optician 2961445606 Practice locations: Edison, NJ

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Santamaria Eye Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568851200000",
    "number": "1841425840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MENLO PARK DRIVE",
            "address_2": "SUITE 408",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "08837",
            "telephone_number": "732-826-5159",
            "fax_number": "732-826-2107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MENLO PARK DRIVE",
            "address_2": "SUITE 408",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "08837",
            "telephone_number": "732-826-5159",
            "fax_number": "732-826-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTAMARIA EYE CENTER P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-19",
        "last_updated": "2019-09-19",
        "status": "A",
        "authorized_official_last_name": "DISLA",
        "authorized_official_first_name": "MENCIA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "732-826-5159",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "MA034125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.