Individual provider Active NPI

Donald J. Seiler, OD

  • Optometrist
  • Summit, NJ
National Provider Identifier
1114911476
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OA 04197 Issued in NJ
Practice address
323 Springfield Ave
Summit, NJ 07901-3626
Phone
(908) 918-0377
Fax
(908) 918-0109
NPI assigned
Sep 1, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OA 04197 NJ Primary

Addresses

Primary practice location

323 Springfield Ave
Summit, NJ 07901-3626

Mailing address

323 Springfield Ave
Summit, NJ 07901-3626
Phone (908) 918-0377

Other identifiers 2

IdentifierTypeStateIssuer
2095103OtherAETNA
144687OtherCOLE VISION

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
I20110602000048 NJ Practitioner - Optometry 7113104035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

323 Springfield Ave
Summit, NJ 07901-3626
Phone (908) 918-0377

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OA 04197NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Eye & Optical LLC Optometrist CurrentSince Aug 30, 2010 Accepting new patients

Locations

323 Springfield Ave
Summit, NJ 07901
Phone (908) 918-0377

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": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1114911476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 SPRINGFIELD AVE",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013626",
            "telephone_number": "908-918-0377",
            "fax_number": "908-918-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 SPRINGFIELD AVE",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013626",
            "telephone_number": "908-918-0377",
            "fax_number": "908-918-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEILER",
        "first_name": "DONALD",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-01",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "OA 04197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2095103",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLE VISION",
            "identifier": "144687",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

Verify at the official NPI Registry.