Individual provider Active NPI

John J Russo, OD

  • Corneal and Contact Management Optometrist
  • Plainsboro, NJ
National Provider Identifier
1114983442
Registry record updated Aug 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
OAO 4698 Issued in NJ
Practice address
10 Schalks Crossing Rd
Plainsboro, NJ 08536-1612
Phone
(609) 275-8989
Fax
(609) 275-9327
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X OAO 4698 NJ Primary

Addresses

Primary practice location

10 Schalks Crossing Rd
Plainsboro, NJ 08536-1612

Mailing address

7 Pannick Dr
Hamilton, NJ 08610-1129
Phone (609) 585-6967

Other identifiers 1

IdentifierTypeStateIssuer
0641930001OtherNJMEDICARE NSC

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
I20050726000234 NJ Practitioner - Optometry 4688601263 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allied Vision Services, PAGroup PAC ID 1254348600, 3 clinicians
Allied Vision NJGroup PAC ID 6002393741, 2 clinicians

Practice addresses (Care Compare)

2495 Route 1
Suite 8
Lawrenceville, NJ 08648-4099
Phone (609) 882-2888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OAO 4698NJMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Vision Services, PA Corneal and Contact Management CurrentSince Dec 1, 2005 Accepting new patients
Total Eye Care Centers, PC Past Accepting new patients
Mercer Vision Associates Past Accepting new patients

Locations

2495 US Highway 1
Ste 8
Lawrenceville, NJ 08648
Phone (609) 882-2888

Organizations & group practices 4

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218153600000",
    "number": "1114983442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 PANNICK DR",
            "city": "HAMILTON",
            "state": "NJ",
            "postal_code": "086101129",
            "telephone_number": "609-585-6967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 SCHALKS CROSSING RD",
            "city": "PLAINSBORO",
            "state": "NJ",
            "postal_code": "085361612",
            "telephone_number": "609-275-8989",
            "fax_number": "609-275-9327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "JOHN",
        "middle_name": "J",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2008-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NJ",
            "license": "OAO 4698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC",
            "identifier": "0641930001",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainsboro, NJ

Sources for this page

Verify at the official NPI Registry.