Individual provider Active NPI

John Mark Engel, M.D.

  • Pediatric Ophthalmology and Strabismus Specialist Physician
  • East Brunswick, NJ
National Provider Identifier
1104806553
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Ophthalmology and Strabismus Specialist PhysicianTaxonomy code 207WX0110X
License
25MA05771200 Issued in NJ
Practice address
4 Cornwall CT
East Brunswick, NJ 08816-3331
Phone
(732) 613-9191
Fax
(732) 613-1139
NPI assigned
Jan 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 25MA05771200 NJ
Pediatric Ophthalmology and Strabismus Specialist Physician 207WX0110X 25MA05771200 NJ Primary

Addresses

Primary practice location

4 Cornwall CT
East Brunswick, NJ 08816-3331

Mailing address

4 Cornwall CT
East Brunswick, NJ 08816-3331
Phone (732) 613-9191

Other identifiers 1

IdentifierTypeStateIssuer
5137802MedicaidNJ

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
25MA05771200NJMDPediatric Ophthalmology and Strabismus Specialist Physician Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wills Eye Ophthalmology Clinic, Inc Ophthalmology CurrentSince Aug 1, 2010 Accepting new patients

Locations

840 Walnut St
Ste 1230
Philadelphia, PA 19107
Phone (215) 440-3160

Interoperability endpoints

  • Direct secure messaging: jengelmd@uceyecenter.direct.eyemdemr.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 1

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": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1104806553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CORNWALL CT",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088163331",
            "telephone_number": "732-613-9191",
            "fax_number": "732-613-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CORNWALL CT",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088163331",
            "telephone_number": "732-613-9191",
            "fax_number": "732-613-1139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGEL",
        "first_name": "JOHN",
        "middle_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "25MA05771200",
            "primary": false
        },
        {
            "code": "207WX0110X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist",
            "state": "NJ",
            "license": "25MA05771200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5137802",
            "state": "NJ"
        }
    ],
    "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 Apr 20, 2020; 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.