Organization Active NPI

NJ Eye Care LLC

  • Optometrist
  • East Brunswick, NJ
National Provider Identifier
1992151716
Registry record updated May 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00621300 Issued in NJ
Legal business name
NJ EYE CARE LLC
Practice address
290 State Route 18
Vision Center
East Brunswick, NJ 08816-1995
Phone
(732) 387-1060
NPI assigned
May 11, 2016
Last updated
May 11, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2016

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

Authorized official

Name
Dr. Nivan Phillips Gendy, O.DNPI 1598998239
Title
Optometrist
Phone
(732) 387-1060

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OA00621300 NJ Primary

Addresses

Primary practice location

290 State Route 18
Vision Center
East Brunswick, NJ 08816-1995

Mailing address

290 State Route 18
East Brunswick, NJ 08816-1995
Phone (732) 387-1060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160720001783 NJ Part B Supplier - Clinic/Group Practice 1153614722 Receives reassigned benefits from 1 practitioner
Practice locations: East Brunswick, NJ

National Provider Directory

National Provider Directory

Locations

290 State Route 18
Ste 1
East Brunswick, NJ 08816
Phone (732) 387-1060

Practitioners & affiliated clinicians

Practitioners 1

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": "1462924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462924800000",
    "number": "1992151716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 STATE ROUTE 18",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088161995",
            "telephone_number": "732-387-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 STATE ROUTE 18",
            "address_2": "VISION CENTER",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088161995",
            "telephone_number": "732-387-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NJ EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-11",
        "last_updated": "2016-05-11",
        "status": "A",
        "authorized_official_last_name": "GENDY",
        "authorized_official_first_name": "NIVAN",
        "authorized_official_middle_name": "PHILLIPS",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "732-387-1060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00621300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.