Individual provider Active NPI

Marc Stuart Wiener, OD

  • Optometrist
  • North Arlington, NJ
National Provider Identifier
1942360565
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4369 Issued in NJ
Practice address
64 Ridge Road
North Arlington, NJ 07031-6318
Phone
(201) 991-2211
Fax
(201) 991-1120
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4369 NJ Primary

Addresses

Primary practice location

64 Ridge Road
North Arlington, NJ 07031-6318

Mailing address

64 Ridge Road
North Arlington, NJ 07031-6318
Phone (201) 991-2211

Other identifiers 2

IdentifierTypeStateIssuer
2931001OtherNJMEDICAID CORP
6323103MedicaidNJ

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121206000024 NJ Practitioner - Optometry 3072765684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

64 Ridge Rd
North Arlington, NJ 07031-6318
Phone (201) 991-2211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4369NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Harold Wiener Optometrist P a Optometrist CurrentSince Jan 2, 2002 Accepting new patients

Locations

64 Ridge Rd
North Arlington, NJ 07031
Phone (201) 991-2211

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942360565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 RIDGE ROAD",
            "city": "NORTH ARLINGTON",
            "state": "NJ",
            "postal_code": "070316318",
            "telephone_number": "201-991-2211",
            "fax_number": "201-991-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 RIDGE ROAD",
            "city": "NORTH ARLINGTON",
            "state": "NJ",
            "postal_code": "070316318",
            "telephone_number": "201-991-2211",
            "fax_number": "201-991-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIENER",
        "first_name": "MARC",
        "middle_name": "STUART",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "4369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID CORP",
            "identifier": "2931001",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6323103",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Arlington, NJ

Sources for this page

Verify at the official NPI Registry.