Individual provider Active NPI

Donald Dean-Rusk Guerrier, O.D

  • Optometrist
  • Newark, NJ
National Provider Identifier
1093934465
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA005529 Issued in NJ
Practice address
677 Mt. Prospect Ave
Newark, NJ 07104
Phone
(973) 350-8224
NPI assigned
Apr 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OA005529 NJ Primary
Optometrist 152W00000X VUT005719 NY

Addresses

Primary practice location

677 Mt. Prospect Ave
Newark, NJ 07104

Mailing address

11 Lincoln PL Apt J
North Brunswick, NJ 08902-4034
Phone (732) 658-3382

Other identifiers 2

IdentifierTypeStateIssuer
09107919MedicaidNY
7508603MedicaidNJ

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
I20031222000630 NJ Practitioner - Optometry 6204734734 Practice locations: Ocean, NJ

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2361 State Route 66
Ocean, NJ 07712-3961
Phone 73248100211

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
27OA005529NJMDOptometrist
VUT005719NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Optical Group LTD Past Accepting new patients
Gail M Blumenthal OD PA Optometrist Past Accepting new patients
Clear Vision Optical, Inc. Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093934465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 LINCOLN PL APT J",
            "city": "NORTH BRUNSWICK",
            "state": "NJ",
            "postal_code": "089024034",
            "telephone_number": "732-658-3382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 MT. PROSPECT AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07104",
            "telephone_number": "973-350-8224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRIER",
        "first_name": "DONALD",
        "middle_name": "DEAN-RUSK",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA005529",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "VUT005719",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09107919",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7508603",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.