Active NPI
Kirti Dave
- Optometrist
- Union City, NJ
National Provider Identifier
1962565952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OA 05381
- Practice address
- 4414 Bergenline Ave
Union City, NJ 07087-5004 - Phone
- (201) 271-1600
- NPI assigned
- Dec 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OA 05381 | NJ | Primary |
Addresses
Primary practice location
4414 Bergenline Ave
Union City, NJ 07087-5004
Mailing address
4414 Bergenline Ave
Union City, NJ 07087-5004
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6690203 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OA 05381 | NJ | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962565952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4414 BERGENLINE AVE",
"city": "UNION CITY",
"state": "NJ",
"postal_code": "070875004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4414 BERGENLINE AVE",
"city": "UNION CITY",
"state": "NJ",
"postal_code": "070875004",
"telephone_number": "201-271-1600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVE",
"first_name": "KIRTI",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NJ",
"license": "OA 05381",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6690203",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Union City, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.