Active NPI
Kenneth L Pearce
- Optician
- East Brunswick, NJ
National Provider Identifier
1003636697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 31TD00357400
- Practice address
- 290 State Route 18
East Brunswick, NJ 08816-1995 - Phone
- (732) 387-1060
- Fax
- (732) 254-1636
- NPI assigned
- Oct 16, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 31TD00357400 | NJ | Primary |
Addresses
Primary practice location
290 State Route 18
East Brunswick, NJ 08816-1995
Mailing address
19 York Dr
Helmetta, NJ 08828-1160
Phone (732) 754-1639
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31TD00357400 | NJ | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729036800000",
"number": "1003636697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 YORK DR",
"city": "HELMETTA",
"state": "NJ",
"postal_code": "088281160",
"telephone_number": "732-754-1639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "290 STATE ROUTE 18",
"city": "EAST BRUNSWICK",
"state": "NJ",
"postal_code": "088161995",
"telephone_number": "732-387-1060",
"fax_number": "732-254-1636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEARCE",
"first_name": "KENNETH",
"middle_name": "L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-10-16",
"last_updated": "2024-10-16",
"certification_date": "2024-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NJ",
"license": "31TD00357400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Brunswick, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.