Liselotte Lore Van Landegem, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA00708400 Issued in NJ

Practice address

127 Newark Ave
Jersey City, NJ 07302-5862

Phone

(201) 333-2768

Fax

(201) 333-3145

NPI assigned

Jun 24, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Liselotte Lore Van Landegem Professional name

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• New York City Health and Hospitals Corporation

  • Clinic/Center
  • New York, NY
  • NPI 1548208127
  Medicare reassignment NPD
• State of New York Comptrollers Office

  • Optometrist
  • New York, NY
  • NPI 1407829856
  Medicare reassignment NPD
• New York City Health and Hospitals Corporation

  • Clinic/Center
  • Bronx, NY
  • NPI 1134137375
  NPD
• New York City Health and Hospitals Corporation

  • Clinic/Center
  • New York, NY
  • NPI 1538943469
  NPD
• State of New York Comptrollers Office

  • Developmental Disabilities Clinic/Center
  • Staten Island, NY
  • NPI 1750469912
  NPD
• Associated Eye Physicians & Surgeons of N.J., P.a.

  • Ophthalmology Physician
  • Union, NJ
  • NPI 1912094079
  NPD (past)

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1942826011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 NEWARK AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073025862",
            "telephone_number": "120-133-3276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 NEWARK AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073025862",
            "telephone_number": "201-333-2768",
            "fax_number": "201-333-3145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33 W 42nd St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100368005",
            "country_code": "US",
            "telephone_number": "212-938-4001",
            "fax_number": "212-938-5831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN LANDEGEM",
        "first_name": "LISELOTTE",
        "middle_name": "LORE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-24",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV009138",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00708400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISELOTTE",
            "last_name": "VAN LANDEGEM",
            "middle_name": "LORE",
            "prefix": "DR.",
            "credential": "27OA00708400",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Optometrist in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.