Samuel Irving Tilonsky, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA00462600 Issued in NJ

Practice address

10 Haddon Ave
Haddon Township, NJ 08108-2706

Phone

(856) 854-6565

Fax

(856) 854-3258

NPI assigned

Oct 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 9

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

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.

• Camcare Health Corporation

  • Federally Qualified Health Center (FQHC)
  • Camden, NJ
  • NPI 1790857696
  Medicare reassignment NPD
• Camcare Health Corporation

  • Federally Qualified Health Center (FQHC)
  • Clementon, NJ
  • NPI 1508035064
  NPD
• Camcare Health Corporation

  • Federally Qualified Health Center (FQHC)
  • Camden, NJ
  • NPI 1912179953
  NPD

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

{
    "created_epoch": "1162080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393286400000",
    "number": "1063598381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 HADDON AVE",
            "city": "HADDON TOWNSHIP",
            "state": "NJ",
            "postal_code": "081082706",
            "telephone_number": "856-854-6565",
            "fax_number": "856-854-3258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 HADDON AVE",
            "city": "HADDON TOWNSHIP",
            "state": "NJ",
            "postal_code": "081082706",
            "telephone_number": "856-854-6565",
            "fax_number": "856-854-3258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILONSKY",
        "first_name": "SAMUEL",
        "middle_name": "IRVING",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-29",
        "last_updated": "2014-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00462600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "35317",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VBA",
            "identifier": "NJ04626",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0082737000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NVA",
            "identifier": "310782",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2282402",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "87925",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "1047635",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVISVISION",
            "identifier": "37913",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "208567",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Tam Thien Tran
• Kimberly Laverne Tribbett, MA, LPC, NCC
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• Victor Ukwu, M.D.

• Optometrist in Haddon Township, NJ
• Providers in Haddon Township, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.