NPIMap

Organization Active NPI

Advanced Eyecare Associates, LLC

  • Optometrist
  • Ledgewood, NJ
National Provider Identifier
1972548824
Registry record updated Sep 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OA00588000 Issued in NJ
Legal business name
ADVANCED EYECARE ASSOCIATES, LLC
Practice address
410 Route 10
Suite 202
Ledgewood, NJ 07852-9658
Phone
(973) 584-2020
Fax
(973) 584-4992
NPI assigned
Jun 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2007

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

Authorized official

Name
Dr. Michael J. Siegel, ODNPI 1427035005
Title
Partner/Optometrist
Phone
(973) 584-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X OA00511801 NJ
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X OA00375200 NJ
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X OA00588000 NJ Primary

Addresses

Primary practice location

410 Route 10
Suite 202
Ledgewood, NJ 07852-9658

Mailing address

410 Route 10
Suite 202
Ledgewood, NJ 07852-9658
Phone (973) 584-2020

National Provider Directory

National Provider Directory

Locations

410 State Route 10
Ste 202
Ledgewood, NJ 07852
Phone (973) 584-2020

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190851200000",
    "number": "1972548824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 ROUTE 10",
            "address_2": "SUITE 202",
            "city": "LEDGEWOOD",
            "state": "NJ",
            "postal_code": "078529658",
            "telephone_number": "973-584-2020",
            "fax_number": "973-584-4992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 ROUTE 10",
            "address_2": "SUITE 202",
            "city": "LEDGEWOOD",
            "state": "NJ",
            "postal_code": "078529658",
            "telephone_number": "973-584-2020",
            "fax_number": "973-584-4992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED EYECARE ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2007-09-27",
        "status": "A",
        "authorized_official_last_name": "SIEGEL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PARTNER/OPTOMETRIST",
        "authorized_official_telephone_number": "973-584-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "OA00511801",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "OA00375200",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "OA00588000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ledgewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.

Verify at the official NPI Registry.