Individual provider Active NPI

Kiran Bhagwan Amesur, M.D.

  • Ophthalmology Physician
  • Ridgewood, NJ
National Provider Identifier
1104900778
Registry record updated May 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MA 07468300 Issued in NJ
Practice address
947 Linwood Ave
Suite 2 South
Ridgewood, NJ 07450-2939
Phone
(201) 857-4751
Fax
(201) 857-4752
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2011

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 MA 07468300 NJ Primary
Ophthalmology Physician 207W00000X 213110 NY

Addresses

Primary practice location

947 Linwood Ave
Suite 2 South
Ridgewood, NJ 07450-2939

Mailing address

947 Linwood Ave
Suite 2 South
Ridgewood, NJ 07450-2939
Phone (201) 857-4751

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040205000490 NJ Practitioner - Ophthalmology 1153214952 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
New York Medical College, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

947 Linwood Ave
Suite 2
Ridgewood, NJ 07450-2939
Phone (201) 857-4751

Hospital & facility affiliations

  • Valley Hospital Hospital, Paramus, NJ, CCN 310012

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA 07468300NJMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amesur Eye Associates, P.a. Ophthalmology CurrentSince May 15, 2011 Accepting new patients
Boyd H Seidenberg Mdpa Ophthalmology Past Accepting new patients

Locations

947 Linwood Ave
Ste 2S
Ridgewood, NJ 07450
Phone (201) 857-4751

Interoperability endpoints

  • Direct secure messaging: kamesur@amesureye.intellechartdirect.net

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305590400000",
    "number": "1104900778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "947 LINWOOD AVE",
            "address_2": "SUITE 2 SOUTH",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074502939",
            "telephone_number": "201-857-4751",
            "fax_number": "201-857-4752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "947 LINWOOD AVE",
            "address_2": "SUITE 2 SOUTH",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074502939",
            "telephone_number": "201-857-4751",
            "fax_number": "201-857-4752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMESUR",
        "first_name": "KIRAN",
        "middle_name": "BHAGWAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2011-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "MA 07468300",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "213110",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

Verify at the official NPI Registry.