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  7. NPI Record 1134183460

DR. PETER JAMES CETTA MD
Complete NPI Record 1134183460
Ophthalmology in Randolph, NJ

NPI Status: Active since April 13, 2006

Contact Information

10 W HANOVER AVE
STE 103
RANDOLPH, NJ
ZIP 07869
Phone: (973) 895-4600
Fax: (973) 895-4604

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Middle Name
  6. Provider Name Prefix Text
  7. Provider Credential Text
  8. Provider First Line Business Mailing Address
  9. Provider Second Line Business Mailing Address
  10. Provider Business Mailing Address City Name
  11. Provider Business Mailing Address State Name
  12. Provider Business Mailing Address Postal Code
  13. Provider Business Mailing Address Country Code If outside U S
  14. Provider Business Mailing Address Telephone Number
  15. Provider Business Mailing Address Fax Number
  16. Provider First Line Business Practice Location Address
  17. Provider Second Line Business Practice Location Address
  18. Provider Business Practice Location Address City Name
  19. Provider Business Practice Location Address State Name
  20. Provider Business Practice Location Address Postal Code
  21. Provider Business Practice Location Address Country Code If outside U S
  22. Provider Business Practice Location Address Telephone Number
  23. Provider Business Practice Location Address Fax Number
  24. Provider Enumeration Date
  25. Last Update Date
  26. Provider Gender Code
  27. Healthcare Provider Taxonomy Code 1
  28. Provider License Number 1
  29. Provider License Number State Code 1
  30. Healthcare Provider Primary Taxonomy Switch 1
  31. Other Provider Identifier 1
  32. Other Provider Identifier Type Code 1
  33. Other Provider Identifier Issuer 1
  34. Other Provider Identifier 2
  35. Other Provider Identifier Type Code 2
  36. Other Provider Identifier Issuer 2
  37. Other Provider Identifier 3
  38. Other Provider Identifier Type Code 3
  39. Other Provider Identifier State 3
  40. Other Provider Identifier Issuer 3
  41. Other Provider Identifier 4
  42. Other Provider Identifier Type Code 4
  43. Other Provider Identifier Issuer 4
  44. Other Provider Identifier 5
  45. Other Provider Identifier Type Code 5
  46. Other Provider Identifier State 5
  47. Other Provider Identifier Issuer 5
  48. Other Provider Identifier 6
  49. Other Provider Identifier Type Code 6
  50. Other Provider Identifier State 6
  51. Other Provider Identifier Issuer 6
  52. Other Provider Identifier 7
  53. Other Provider Identifier Type Code 7
  54. Other Provider Identifier Issuer 7
  55. Other Provider Identifier 8
  56. Other Provider Identifier Type Code 8
  57. Other Provider Identifier Issuer 8
  58. Other Provider Identifier 9
  59. Other Provider Identifier Type Code 9
  60. Other Provider Identifier Issuer 9
  61. Other Provider Identifier 10
  62. Other Provider Identifier Type Code 10
  63. Other Provider Identifier State 10
  64. Other Provider Identifier Issuer 10
  65. Other Provider Identifier 11
  66. Other Provider Identifier Type Code 11
  67. Other Provider Identifier State 11
  68. Other Provider Identifier Issuer 11
  69. Other Provider Identifier 12
  70. Other Provider Identifier Type Code 12
  71. Other Provider Identifier Issuer 12
  72. Other Provider Identifier 13
  73. Other Provider Identifier Type Code 13
  74. Other Provider Identifier Issuer 13
  75. Other Provider Identifier 14
  76. Other Provider Identifier Type Code 14
  77. Other Provider Identifier State 14
  78. Other Provider Identifier Issuer 14
  79. Other Provider Identifier 15
  80. Other Provider Identifier Type Code 15
  81. Other Provider Identifier State 15
  82. Other Provider Identifier Issuer 15
  83. Other Provider Identifier 16
  84. Other Provider Identifier Type Code 16
  85. Other Provider Identifier Issuer 16
  86. Other Provider Identifier 17
  87. Other Provider Identifier Type Code 17
  88. Other Provider Identifier State 17
  89. Other Provider Identifier Issuer 17
  90. Is Sole Proprietor

Complete NPI Dataset

This page represents the complete record for NPI 1134183460. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1134183460
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: PETER
The first name of the provider, if the provider is an individual.
Provider Middle Name: JAMES
The middle name of the provider, if the provider is an individual.
Provider Name Prefix Text: DR.
The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Provider Credential Text: MD
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address: 10 W HANOVER AVE
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Second Line Business Mailing Address: STE 103
The second line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider second line location address’’.
Provider Business Mailing Address City Name: RANDOLPH
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: NJ
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 07869
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 9738954600
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number: 9738954604
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: 10 W HANOVER AVE
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location Address: STE 103
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: RANDOLPH
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: NJ
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 07869
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 9738954600
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 9738954604
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 4/13/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 5/16/2008
The date that a record was last updated or changed.
Provider Gender Code: M
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 207W00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: MA36318
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: NJ
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: Y
Other Provider Identifier 1: 052811440
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 1: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier Issuer 1: RR MEDICARE
Other Provider Identifier 2: IS269
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 2: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier Issuer 2: OXFORD
Other Provider Identifier 3: 13254
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 3: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 3: NJ
Other Provider Identifier Issuer 3: OPERATING ENGINEERS OF LO
Other Provider Identifier 4: 222302679
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 4: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier Issuer 4: GEHA
Other Provider Identifier 5: 010036318NJ01
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 5: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 5: NY
Other Provider Identifier Issuer 5: ANTHEM HEALTH
Other Provider Identifier 6: 53A861
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 6: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 6: NY
Other Provider Identifier Issuer 6: WELL CHOICE
Other Provider Identifier 7: 0038164
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 7: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier Issuer 7: AETNA
Other Provider Identifier 8: 0951265
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 8: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier Issuer 8: CIGNA HEALTHCARE
Other Provider Identifier 9: 0K0704
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 9: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier Issuer 9: HEALTH NET OF THE NORTHEA
Other Provider Identifier 10: 9537062
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 10: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 10: NY
Other Provider Identifier Issuer 10: MULTIPLAN
Other Provider Identifier 11: 0076931000
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 11: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 11: NJ
Other Provider Identifier Issuer 11: AMERIHEALTH HMO POS
Other Provider Identifier 12: 1323553
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 12: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier Issuer 12: MAIL HANDLERS BENEFIT PLA
Other Provider Identifier 13: 447459
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 13: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier Issuer 13: UNITED HEALTHCARE
Other Provider Identifier 14: 9537062
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 14: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 14: NY
Other Provider Identifier Issuer 14: GHI
Other Provider Identifier 15: S46801
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 15: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 15: IL
Other Provider Identifier Issuer 15: AMERICAN IMAGING MGMT
Other Provider Identifier 16: 1323553
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 16: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier Issuer 16: IL AZ FIRST HEALTH
Other Provider Identifier 17: 895564
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 17: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 17: PA
Other Provider Identifier Issuer 17: AMERIHEALTH PPO
Is Sole Proprietor: Y
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No