Individual provider Active NPI

A J Friedman, OD

  • Optometrist
  • Union, NJ
National Provider Identifier
1114087889
Registry record updated Sep 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
NJ3466 Issued in NJ
Practice address
1767 Morris Ave
Union, NJ 07083-3532
Phone
(908) 964-6046
Fax
(908) 687-7956
NPI assigned
Dec 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NJ3466 NJ Primary

Addresses

Primary practice location

1767 Morris Ave
Union, NJ 07083-3532

Mailing address

229 East Mt Pleasant Ave
Livingston, NJ 07039-0000
Phone (973) 992-0612

Other identifiers 1

IdentifierTypeStateIssuer
0730203MedicaidNJ

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
I20110131000900 NJ Practitioner - Optometry 6608055025 Practice locations: Livingston, NJ; Union, NJ

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

229 E Mount Pleasant Ave
Livingston, NJ 07039-3209
Phone (973) 992-0612

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NJ3466NJMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380153600000",
    "number": "1114087889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 EAST MT PLEASANT AVE",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070390000",
            "telephone_number": "973-992-0612",
            "fax_number": "973-992-3738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1767 MORRIS AVE",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070833532",
            "telephone_number": "908-964-6046",
            "fax_number": "908-687-7956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "A",
        "middle_name": "J",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2013-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "NJ3466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0730203",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, NJ

Sources for this page

Verify at the official NPI Registry.