Individual provider Active NPI

Andrea Friedman, O.D.

  • Optometrist
  • Montclair, NJ
National Provider Identifier
1942683917
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2955 Issued in CT
Practice address
103 Park St
Suite 1
Montclair, NJ 07042-5913
Phone
(973) 744-4334
NPI assigned
Jul 8, 2015
Last updated
Jul 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2955 CT Primary

Addresses

Primary practice location

103 Park St
Suite 1
Montclair, NJ 07042-5913

Mailing address

103 Park St
Montclair, NJ 07042-5913

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160210000365 VA Practitioner - Optometry 2567765563
I20251027003088 NY Practitioner - Optometry 2567765563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

159 1St Ave
New York, NY 10003-3067

PO Box
Suite 4
Dumont, NJ 07628

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008340NYMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
East Side 2020 Vision Optometrist CurrentSince Aug 3, 2025 Accepting new patients
Montclair Vision Services Optometrist PastSince Jul 22, 2025 Accepting new patients
Dna Management Corp. PastSince Aug 3, 2025 Accepting new patients

Locations

159 1st Ave
New York, NY 10003
Phone (212) 228-0950

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1436313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1942683917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 PARK ST",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070425913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 PARK ST",
            "address_2": "SUITE 1",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070425913",
            "telephone_number": "973-744-4334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "ANDREA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-08",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "2955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, NJ

Sources for this page

Verify at the official NPI Registry.