Broadway Optical LLC
NPI 1215721824ActiveOrganization· Optometrist· Palisades Park, NJ
Optometrist in Palisades Park, New Jersey, registered in NPPES in April 2025. The authorized official on file is Jeanine Elizabeth Graves, OD, Optometrist.
Overview
| NPI | 1215721824 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 8, 2025 |
| Last updated in NPPES | Apr 8, 2025 |
| Certified by provider | Apr 8, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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