Forrest Mark Waterman, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA00695100 Issued in NJ

Practice address

928 NJ-73
Evesham Township, NJ 08053

Phone

(856) 596-8883

NPI assigned

Feb 4, 2020

Last updated

Jul 21, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Zupsic Eye Associates LLC

  • Optometrist
  • Glassboro, NJ
  • NPI 1699272674
  Medicare reassignment NPD
• Vutt

  dba VUTT Optical and Sunglasses

  • Eyewear Supplier
  • Burlington, NJ
  • NPI 1780950204
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1580774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1003447400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 TANNER RD",
            "city": "NEDROW",
            "state": "NY",
            "postal_code": "131209719",
            "telephone_number": "315-481-3279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 NJ-73",
            "city": "EVESHAM TOWNSHIP",
            "state": "NJ",
            "postal_code": "08053",
            "telephone_number": "856-596-8883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERMAN",
        "first_name": "FORREST",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-04",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00695100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Community Options, Inc.
• Purvi Patel, PHARM D

• Optometrist in Evesham Township, NJ
• Providers in Evesham Township, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.