Individual provider Active NPI

David Alex Samuel, O.D.

  • Optometrist
  • Basking Ridge, NJ
National Provider Identifier
1073921508
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00654700 Issued in NJ
Practice address
554 Allen Rd
Basking Ridge, NJ 07920-3848
Phone
(908) 224-1608
Fax
(908) 224-1609
NPI assigned
Jul 28, 2014
Last updated
Sep 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OA00654700 NJ Primary

Addresses

Primary practice location

554 Allen Rd
Basking Ridge, NJ 07920-3848

Mailing address

554 Allen Rd
Basking Ridge, NJ 07920-3848
Phone (908) 224-1608

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
I20140922001530 NJ Practitioner - Optometry 9032338140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

200 Promenade Blvd
Bridgewater, NJ 08807-3456
Phone (914) 500-4962

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OA00654700NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
JDN Vista LLC Optometrist CurrentSince Mar 1, 2017 Accepting new patients
Harold S Lappin MD PA Past Accepting new patients
Eye and Laser Surgery Centers of New Jersey LLC Past Accepting new patients

Locations

200 Promenade Blvd
Bridgewater, NJ 08807
Phone (732) 357-1168

Organizations & group practices 4

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": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1073921508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "554 ALLEN RD",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079203848",
            "telephone_number": "908-224-1608",
            "fax_number": "908-224-1609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "554 ALLEN RD",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079203848",
            "telephone_number": "908-224-1608",
            "fax_number": "908-224-1609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "DAVID",
        "middle_name": "ALEX",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-28",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00654700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Basking Ridge, NJ

Sources for this page

Verify at the official NPI Registry.