Active NPI
Eric M Waldman, OD
- Optometrist
- Pasaic, NJ
National Provider Identifier
1851361968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- A003524
- Practice address
- 607 Main Ave
Pasaic, NJ 07055 - Phone
- (973) 473-3384
- Fax
- (973) 473-0366
- NPI assigned
- Jan 23, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | A003524 | NJ | Primary |
| Optometrist | 152W00000X | 3311 | NY | |
| Optometrist | 152W00000X | 4949 | PA |
Addresses
Primary practice location
607 Main Ave
Pasaic, NJ 07055
Mailing address
607 Main Ave
Pasaic, NJ 07055
Phone (973) 473-3384
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0530107 | Medicaid | NJ |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A003524 | NJ | MD | Optometrist |
| 3311 | NY | MD | Optometrist |
| 4949 | PA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Supreme Eye Center Inc | Optometrist | Past | Accepting new patients |
| Supreme Solutions Inc | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Optometrist
- Rockaway, NJ
- NPI 1366547838
-
- Eyewear Supplier
- Rockaway, NJ
- NPI 1306968136
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278979200000",
"number": "1851361968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "607 MAIN AVE",
"city": "PASAIC",
"state": "NJ",
"postal_code": "07055",
"telephone_number": "973-473-3384",
"fax_number": "973-473-0366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "607 MAIN AVE",
"city": "PASAIC",
"state": "NJ",
"postal_code": "07055",
"telephone_number": "973-473-3384",
"fax_number": "973-473-0366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALDMAN",
"first_name": "ERIC",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-23",
"last_updated": "2010-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NJ",
"license": "A003524",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "3311",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PA",
"license": "4949",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0530107",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.