MEDICARE: ASSOCIATED RETINAL CONSULTANTS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician
2	152W00000X	Optometrist

General Provider Information

NPI Number	:	1891686135
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSOCIATED RETINAL CONSULTANTS LLC

Provider Business Mailing Address
First Line	:	420 MOUNTAIN AVE FL 4
Second Line	:
City	:	NEW PROVIDENCE
State	:	NJ
Zip	:	07974-2736
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 HOMESTEAD DR STE A
Second Line	:
City	:	COLUMBUS
State	:	NJ
Zip	:	08022-1005
Country	:	US
Telephone Number	:	609-298-0888
Fax Number	:

Authorized Official
Title or Position	:	VP, CREDENTIALING & PAYER RELATIONS
Name	:	JENNIFER HASTIE
Credential	:
Telephone Number	:	214-415-9671

Provider Enumeration Date	:	07/14/2025
Last Update Date	:	07/14/2025

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