PEDIATRIC OPHTHALMOLOGY OF NJ, P.C.
NPI 1164460218
Ophthalmology in Wayne, NJ

NPI Status: Active since June 02, 2006

Contact Information

57 WILLOWBROOK BLVD
SUITE 411
WAYNE, NJ
ZIP 07470
Phone: (973) 256-4111
Fax: (973) 256-3719

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  • Organization
  • Ophthalmology
  • Accepts Insurance
  • CLIA Number: 31D1073501
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 09-10-2027

About PEDIATRIC OPHTHALMOLOGY OF NJ, P.C.

This page provides the complete NPI Profile along with additional information for Pediatric Ophthalmology Of Nj, P.c., a provider established in Wayne, New Jersey operating as a Ophthalmology. The healthcare provider is registered in the NPI registry with number 1164460218 assigned on June 2006. The practitioner's primary taxonomy code is 207W00000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. Pediatric Ophthalmology Of Nj, P.c. operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Kevin J. Mickey M.d. (President)

NPI
1164460218
Provider Name
PEDIATRIC OPHTHALMOLOGY OF NJ, P.C.
Entity Type
Organization
Location Address
57 WILLOWBROOK BLVD SUITE 411 WAYNE, NJ 07470
Location Phone
(973) 256-4111
Location Fax
(973) 256-3719
Mailing Address
57 WILLOWBROOK BLVD SUITE 411 WAYNE, NJ 07470
Mailing Phone
(973) 256-4111
Mailing Fax
(973) 256-3719
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-02-2006
Last Update Date
04-20-2020
Code Navigator

Ophthalmologists like Pediatric Ophthalmology Of Nj, P.c. specialize in diagnosing and treating eye conditions. They may perform surgeries to correct vision issues or prevent vision loss due to diseases like glaucoma. Additionally, they can provide eyeglasses, prescribe contact lenses, and offer other vision-related services.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Ophthalmology

Taxonomy Code
207W00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207WX0110XAllopathic & Osteopathic Physicians

Ophthalmology
Pediatric Ophthalmology and Strabismus Specialist

 

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Principal Bronze HSA - EPO
  • Principal Bronze HSA + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

KEVIN J. MICKEY M.D.

Authorized Official Title
PRESIDENT
Authorized Official Phone
(973) 256-4111

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
8550204MEDICAID (05)NJ 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
31D1073501
Facility Type
Physician Office
Certificate Effective Date
September 11, 2025
Certificate Expiration Date
September 10, 2027
Laboratory Director
ERENA TRESKOKA
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Pediatric Ophthalmology Of Nj, P.c. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for PEDIATRIC OPHTHALMOLOGY OF NJ, P.C.

There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1164460218, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 52. The final step is to find the difference between that total and the next multiple of ten (60 - 52 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
4
Unchanged
Pos 5
4
Doubled → 8
Pos 6
6
Unchanged
Pos 7
0
Doubled → 0
Pos 8
2
Unchanged
Pos 9
1
Doubled → 2
Check
8
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 4 → 8 0 → 0 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 1 + 2 + 4 + 8 + 6 + 0 + 2 + 2 + 24 = 52

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 52 is 60. The difference is the calculated check digit.

60 - 52 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1164460218.

Other Providers at the Same Location


The following 17 providers are registered at the same or a nearby location.

Pediatrics (Adolescent Medicine)
57 WILLOWBROOK BLVD, SUITE 421
WAYNE, NJ 07470
Pediatrics (Adolescent Medicine)
57 WILLOWBROOK BLVD, SUITE 421
WAYNE, NJ 07470
Pediatrics (Adolescent Medicine)
57 WILLOWBROOK BLVD, SUITE 421
WAYNE, NJ 07470
Pediatrics (Adolescent Medicine)
57 WILLOWBROOK BLVD, SUITE 421
WAYNE, NJ 07470
Pediatrics (Adolescent Medicine)
57 WILLOWBROOK BLVD, SUITE 421
WAYNE, NJ 07470
Obstetrics & Gynecology
57 WILLOWBROOK BLVD
WAYNE, NJ 07470
Obstetrics & Gynecology
57 WILLOWBROOK BLVD, SECOND FLOOR
WAYNE, NJ 07470
Obstetrics & Gynecology (Maternal & Fetal Medicine)
57 WILLOWBROOK BLVD, SUITE 301
WAYNE, NJ 07470
Obstetrics & Gynecology (Reproductive Endocrinology)
57 WILLOWBROOK BLVD
WAYNE, NJ 07470
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
57 WILLOWBROOK BLVD, 2ND FLOOR
WAYNE, NJ 07470
Ophthalmology
57 WILLOWBROOK BLVD, SUITE 411
WAYNE, NJ 07470
Ophthalmology
57 WILLOWBROOK BLVD, SUITE 411
WAYNE, NJ 07470
Family Medicine
57 WILLOWBROOK BLVD
WAYNE, NJ 07470
Obstetrics & Gynecology
57 WILLOWBROOK BLVD, SUITE 301
WAYNE, NJ 07470
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
57 WILLOWBROOK BLVD
WAYNE, NJ 07470
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
57 WILLOWBROOK BLVD, FL 2
WAYNE, NJ 07470
Preventive Medicine (Preventive Medicine/Occupational Environmental Medicine)
57 WILLOWBROOK BLVD
WAYNE, NJ 07470

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1164460218, enumerated as an "organization" on June 02, 2006.

The provider is located at 57 WILLOWBROOK BLVD SUITE 411 WAYNE, NJ 07470 and the phone number is (973) 256-4111.

Ophthalmology with taxonomy code 207W00000X.

The provider might be accepting Accepts: Ambetter Health, Ambetter Health of Delaware,. Please consult your insurance carrier or call the provider to verify.