NPIMap

Organization Active NPI

Mazzuca Eye and Laser Centers,PA

  • Ophthalmology Physician
  • Pennsville, NJ
National Provider Identifier
1942255831
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
MAZZUCA EYE AND LASER CENTERS,PA
Practice address
48 N Broadway
Pennsville, NJ 08070-1754
Phone
(856) 678-4800
NPI assigned
May 23, 2006
Last updated
May 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Authorized official

Name
Wendy Ann Marandola
Title
Office Manager
Phone
(856) 678-4800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X Primary

Addresses

Primary practice location

48 N Broadway
Pennsville, NJ 08070-1754

Mailing address

48 N Broadway
Pennsville, NJ 08070-1754
Phone (856) 678-4800

Other identifiers 4

IdentifierTypeStateIssuer
2175328000OtherNJAMERIHEALTH PPO
2272222000OtherNJAMERIHEALTH HMO
5144456OtherNJAETNA
CE7177OtherNJPALMETTO GBA

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070111000147 NJ Part B Supplier - Clinic/Group Practice 5698775906 Receives reassigned benefits from 4 practitioners
Practice locations: Swedesboro, NJ; Pennsville, NJ
O20100930086228 NJ DME Supplier - Physician - Ophthalmology 5698775906 Practice locations: Pennsville, NJ

National Provider Directory

National Provider Directory

Locations

48 N Broadway
Pennsville, NJ 08070
Phone (856) 678-4800

48 N Broadway
Ste A
Pennsville, NJ 08070
Phone (856) 678-4800

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": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211414400000",
    "number": "1942255831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 N BROADWAY",
            "city": "PENNSVILLE",
            "state": "NJ",
            "postal_code": "080701754",
            "telephone_number": "856-678-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 N BROADWAY",
            "city": "PENNSVILLE",
            "state": "NJ",
            "postal_code": "080701754",
            "telephone_number": "856-678-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAZZUCA EYE AND LASER CENTERS,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2008-05-22",
        "status": "A",
        "authorized_official_last_name": "MARANDOLA",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "856-678-4800"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH PPO",
            "identifier": "2175328000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH HMO",
            "identifier": "2272222000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5144456",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "CE7177",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pennsville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.