Organization Active NPI

Optical Palace LLC

  • Ophthalmic Technician/Technologist
  • Jersey City, NJ
National Provider Identifier
1982751897
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Technician/TechnologistTaxonomy code 156FX1100X
License
TD3405 Issued in NJ
Legal business name
OPTICAL PALACE LLC
Practice address
910 Bergen Ave
Jersey City, NJ 07306-4314
Phone
(201) 610-0980
Fax
(201) 610-0982
NPI assigned
Jan 4, 2007
Last updated
Jul 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Authorized official

Name
Mr. Parag Champaklal Raithatha, OPTICIAN
Title
Partner
Phone
(201) 610-0980

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmic Technician/TechnologistGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1100X TD3405 NJ Primary

Addresses

Primary practice location

910 Bergen Ave
Jersey City, NJ 07306-4314

Mailing address

910 Bergen Ave
Jersey City, NJ 07306-4314
Phone (201) 610-0980

Other identifiers 1

IdentifierTypeStateIssuer
8148805MedicaidNJ

National Provider Directory

National Provider Directory

Locations

910 Bergen Ave
Jersey City, NJ 07306
Phone (201) 610-0980

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783900800000",
    "number": "1982751897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 BERGEN AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073064314",
            "telephone_number": "201-610-0980",
            "fax_number": "201-610-0822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 BERGEN AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073064314",
            "telephone_number": "201-610-0980",
            "fax_number": "201-610-0982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTICAL PALACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A",
        "authorized_official_last_name": "RAITHATHA",
        "authorized_official_first_name": "PARAG",
        "authorized_official_middle_name": "CHAMPAKLAL",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "201-610-0980",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OPTICIAN"
    },
    "taxonomies": [
        {
            "code": "156FX1100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Ophthalmic",
            "state": "NJ",
            "license": "TD3405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8148805",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.