Randy S Nissinoff, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA00506100 Issued in NJ

Practice address

1278 Hooper Ave
Toms River, NJ 08753-3324

Phone

(732) 505-0533

Fax

(732) 505-6572

NPI assigned

May 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 18

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

EyewellnissGroup PAC ID 6406222488, 8 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Eyewellniss

  • Health Service Clinic/Center
  • Livingston, NJ
  • NPI 1578298535

  NJ

  Medicare reassignment Care Compare group NPD
• Eye Health Group of Princeton, LLC

  • Optometrist
  • Lawrenceville, NJ
  • NPI 1538460977
  NPD (past) Authorized official
• Ehg NJ Service LLC

  • Optometrist
  • Springfield, NJ
  • NPI 1285222877
  NPD
• The Eye Health Group of Totowa, LLC

  • Optometrist
  • Totowa, NJ
  • NPI 1093768343
  NPD
• Eye Health Group of Springfield, LLC

  • Optometrist
  • Springfield, NJ
  • NPI 1154373819
  NPD (past)
• Jeyeye Inc.

  • Durable Medical Equipment & Medical Supplies
  • Toms River, NJ
  • NPI 1235340050
  NPD (past)
• The Eye Health Group of Mays Landing LLC

  • Optometrist
  • Mays Landing, NJ
  • NPI 1134399520
  NPD (past)
• The Eye Health Group of Paramus, LLC

  • Optometrist
  • Paramus, NJ
  • NPI 1104879451
  NPD (past)
• The Eye Health Group, LLC

  • Optometrist
  • Iselin, NJ
  • NPI 1669424495
  NPD (past)
• Luxottica of America Inc

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210291200000",
    "number": "1023061348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1278 HOOPER AVE",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087533324",
            "telephone_number": "732-505-0533",
            "fax_number": "732-505-6572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1278 HOOPER AVE",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087533324",
            "telephone_number": "732-505-0533",
            "fax_number": "732-505-6572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISSINOFF",
        "first_name": "RANDY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2008-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00506100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION",
            "identifier": "043721860",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION",
            "identifier": "204100761",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION",
            "identifier": "223791991",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION",
            "identifier": "204100926",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NVA",
            "identifier": "23545",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1316769",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NVA",
            "identifier": "23731",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2855956",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NVA",
            "identifier": "311501",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NVA",
            "identifier": "22678",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3843273",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOCAL 825 OPERATING ENGINEERS",
            "identifier": "62810",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYE MED",
            "identifier": "911575",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1316771",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION",
            "identifier": "510661700",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION",
            "identifier": "203095550",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1316770",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NVA",
            "identifier": "23793",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jill Nicolosi, LCSW
• Alexandra Nicotra, LPC
• Nikunj Mehta Mdpa
• Neil Abraham Ninan, M.D.
• Mitchell Nisenson, DDS
• Laura A Nitka, MSW LCSW
• NJ Community Care Center
• NJ Community Spine and Pain LLC
• NJ Heart Institute, PA
• Lucas Motta Nogueira, PT, DPT

• Optometrist in Toms River, NJ
• Providers in Toms River, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.