Individual provider Active NPI

Richard S Witlin, MD

  • Ophthalmology Physician
  • East Brunswick, NJ
National Provider Identifier
1063459212
Registry record updated Aug 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MA03593300 Issued in NJ
Practice address
557 Cranbury Rd
Suite 15
East Brunswick, NJ 08816-5419
Phone
(732) 698-9300
Fax
(732) 625-0107
NPI assigned
May 31, 2006
Last updated
Aug 6, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MA03593300 NJ Primary

Addresses

Primary practice location

557 Cranbury Rd
Suite 15
East Brunswick, NJ 08816-5419

Mailing address

557 Cranbury Rd
Suite 15
East Brunswick, NJ 08816-5419
Phone (732) 698-9300

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA03593300NJMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
BP Immediate Medical Care, PC PastSince Nov 19, 2019 Accepting new patients
Richard S. Witlin MD PC Ophthalmology PastSince Jul 1, 2001 Accepting new patients
Freehold Ophthalmology, LLC Ophthalmology Past Accepting new patients
Associated Eye Physicians & Surgeons of N.J., P.a. Ophthalmology Past Accepting new patients
Foholdings, LLC Ophthalmology PastSince Jul 1, 2001 Accepting new patients
Rummel Eyecare Lowvision Care Center LLC PastSince Jun 30, 2011 Accepting new patients

Organizations & group practices 6

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281052800000",
    "number": "1063459212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "557 CRANBURY RD",
            "address_2": "SUITE 15",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088165419",
            "telephone_number": "732-698-9300",
            "fax_number": "732-625-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 CRANBURY RD",
            "address_2": "SUITE 15",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088165419",
            "telephone_number": "732-698-9300",
            "fax_number": "732-625-0107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITLIN",
        "first_name": "RICHARD",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2010-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "MA03593300",
            "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 Aug 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.