Individual provider Active NPI

Arnold D Craft, O.D.

  • Optometrist
  • Elmwood Park, NJ
National Provider Identifier
1104993203
Registry record updated Nov 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00467200 Issued in NJ
Practice address
201A Market St
Elmwood Park, NJ 07407-1405
Phone
(201) 796-0030
Fax
(201) 796-3448
NPI assigned
Nov 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OA00467200 NJ Primary

Addresses

Primary practice location

201A Market St
Elmwood Park, NJ 07407-1405

Mailing address

62 George Russell Way
Clifton, NJ 07013-2655
Phone (973) 688-8145

Other identifiers 1

IdentifierTypeStateIssuer
4812506MedicaidNJ

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
I20120314000480 NJ Practitioner - Optometry 7214196096 Practice locations: Elmwood Park, NJ

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1986
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

201 A Market St
Elmwood Park, NJ 07407-1405
Phone (201) 796-0030

201 Market St a
Elmwood Park, NJ 07407-1405

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OA00467200NJMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321833600000",
    "number": "1104993203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 GEORGE RUSSELL WAY",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070132655",
            "telephone_number": "973-688-8145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201A MARKET ST",
            "city": "ELMWOOD PARK",
            "state": "NJ",
            "postal_code": "074071405",
            "telephone_number": "201-796-0030",
            "fax_number": "201-796-3448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAFT",
        "first_name": "ARNOLD",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2011-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00467200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4812506",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmwood Park, NJ

Sources for this page

Verify at the official NPI Registry.