NPIMap

Organization Active NPI

MRL Vision Associates Inc

  • Optometrist
  • Pine Beach, NJ
National Provider Identifier
1912010240
Registry record updated Jun 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27T00093300 Issued in NJ
Legal business name
MRL VISION ASSOCIATES INC
Practice address
90 Rte 9
Pine Beach, NJ 08741
Phone
(732) 736-1700
Fax
(732) 736-1781
NPI assigned
Aug 17, 2006
Last updated
Jun 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2008

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

Authorized official

Name
Dr. Marc J Ullman, ODNPI 1619005832
Title
Optometric Physician
Phone
(732) 736-1700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 27T00093300 NJ Primary

Addresses

Primary practice location

90 Rte 9
Pine Beach, NJ 08741

Mailing address

90 Rte 9
Pine Beach, NJ 08741
Phone (732) 736-1700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041221000121 NJ Part B Supplier - Clinic/Group Practice 1850359019 Receives reassigned benefits from 2 practitioners
Practice locations: Pine Beach, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212624000000",
    "number": "1912010240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 RTE 9",
            "city": "PINE BEACH",
            "state": "NJ",
            "postal_code": "08741",
            "telephone_number": "732-736-1700",
            "fax_number": "732-736-1781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 RTE 9",
            "city": "PINE BEACH",
            "state": "NJ",
            "postal_code": "08741",
            "telephone_number": "732-736-1700",
            "fax_number": "732-736-1781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MRL VISION ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2008-06-05",
        "status": "A",
        "authorized_official_last_name": "ULLMAN",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OPTOMETRIC PHYSICIAN",
        "authorized_official_telephone_number": "732-736-1700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27T00093300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Beach, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2008; 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.