Individual provider Active NPI

Vittorio Mena Jr., O.D.

  • Corneal and Contact Management Optometrist
  • Rutherford, NJ
National Provider Identifier
1942698717
Registry record updated Jan 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
27OA00657300 Issued in NJ
Practice address
31 Park Ave
Rutherford, NJ 07070-1711
Phone
(201) 939-2463
Fax
(201) 939-1454
NPI assigned
Jan 2, 2015
Last updated
Jan 26, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 27OA00657300 NJ Primary

Addresses

Primary practice location

31 Park Ave
Rutherford, NJ 07070-1711

Mailing address

1430 Main Ave
Clifton, NJ 07011-2146
Phone (201) 945-2525

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
I20180403000406 NJ Practitioner - Optometry 9830468701 Practice locations: Clifton, NJ; Fairview, NJ

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Robert Schorn Purnell LLC PastSince Jan 20, 2013 Accepting new patients

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, 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": "1420156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516924800000",
    "number": "1942698717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 MAIN AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070112146",
            "telephone_number": "201-945-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 PARK AVE",
            "city": "RUTHERFORD",
            "state": "NJ",
            "postal_code": "070701711",
            "telephone_number": "201-939-2463",
            "fax_number": "201-939-1454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENA",
        "first_name": "VITTORIO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-02",
        "last_updated": "2018-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NJ",
            "license": "27OA00657300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rutherford, NJ

Sources for this page

Verify at the official NPI Registry.