Individual provider Active NPI

Robert Kahn, O.D.

  • Optometrist
  • Fair Lawn, NJ
National Provider Identifier
1013097732
Registry record updated Jan 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4351 Issued in NJ
Practice address
23-55 Fair Lawn Avenue
Fair Lawn, NJ 07410-3407
Phone
(201) 796-2873
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4351 NJ Primary

Addresses

Primary practice location

23-55 Fair Lawn Avenue
Fair Lawn, NJ 07410-3407

Mailing address

23-55 Fair Lawn Avenue
Fair Lawn, NJ 07410-3407
Phone (201) 796-2873

Other identifiers 4

IdentifierTypeStateIssuer
4214237OtherNJCIGNA
P1088215OtherNJOXFORD
0516598OtherNJAETNA
223199290OtherNJHORIZON

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100322000816 NJ Practitioner - Optometry 1355476870 Practice locations: Fair Lawn, NJ

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

23 -55 Fair Lawn Ave
Fair Lawn, NJ 07410-3407
Phone (201) 796-2873

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4351NJMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294099200000",
    "number": "1013097732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23-55 FAIR LAWN AVENUE",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074103407",
            "telephone_number": "201-796-2873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23-55 FAIR LAWN AVENUE",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074103407",
            "telephone_number": "201-796-2873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAHN",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2011-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "4351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4214237",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1088215",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0516598",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON",
            "identifier": "223199290",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

Verify at the official NPI Registry.