Individual provider Active NPI

James Anglim Jr., O.D.

  • Optometrist
  • Piscataway, NJ
National Provider Identifier
1003903717
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00555800 Issued in NJ
Practice address
1303 Centennial Ave
Piscataway, NJ 08854-4321
Phone
(732) 562-1804
Fax
(732) 562-1741
NPI assigned
Oct 6, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OA00555800 NJ Primary

Addresses

Primary practice location

1303 Centennial Ave
Piscataway, NJ 08854-4321

Mailing address

1303 Centennial Ave
Piscataway, NJ 08854-4321
Phone (732) 562-1804

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU
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

Enrollment IDStateProvider typePAC IDDetails
I20210308002583 GU Practitioner - Optometry 7012067432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Takecare Insurance Company IncGroup PAC ID 8325951239, 28 clinicians

Practice addresses (Care Compare)

548 S Marine Corps Dr
Tamuning, GU 96913-3539
Phone (671) 646-5825

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OA00555800NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Takecare Insurance Company Inc. Optometrist CurrentSince Feb 16, 2021 Accepting new patients

Locations

548 S Marine Corps Dr
Tamuning, GU 96913
Phone (671) 646-5824

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JAEGCA/Endpoint/JAEGCA

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003903717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 CENTENNIAL AVE",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "088544321",
            "telephone_number": "732-562-1804",
            "fax_number": "732-562-1741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 CENTENNIAL AVE",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "088544321",
            "telephone_number": "732-562-1804",
            "fax_number": "732-562-1741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGLIM",
        "first_name": "JAMES",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00555800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Piscataway, NJ

Sources for this page

Verify at the official NPI Registry.