Individual provider Active NPI

Sean Patrick Phibbs, OD

  • Optometrist
  • Sea Girt, NJ
National Provider Identifier
1144223579
Registry record updated Mar 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
NJ4756 Issued in NJ
Practice address
701 Sea Girt Ave
Sea Girt, NJ 08750-2803
Phone
(732) 974-3937
Fax
(732) 974-6899
NPI assigned
May 31, 2005
Last updated
Mar 24, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NJ4756 NJ Primary

Addresses

Primary practice location

701 Sea Girt Ave
Sea Girt, NJ 08750-2803

Mailing address

701 Sea Girt Ave
Sea Girt, NJ 08750-2803
Phone (732) 974-3937

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
I20110420000131 NJ Practitioner - Optometry 6608999180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emerald Eyes IncGroup PAC ID 4587872312, 2 clinicians

Practice addresses (Care Compare)

701 Sea Girt Ave
Sea Girt, NJ 08750-2803

Merit-based Incentive Payment System (MIPS)

Final score
13.33 of 100Reported as individual
Quality
26.67
Improvement activities
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NJ4756NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Emerald Eyes Inc Optometrist CurrentSince Oct 1, 1997 Accepting new patients

Locations

701 Sea Girt Ave
Sea Girt, NJ 08750
Phone (732) 974-3937

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395619200000",
    "number": "1144223579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 SEA GIRT AVE",
            "city": "SEA GIRT",
            "state": "NJ",
            "postal_code": "087502803",
            "telephone_number": "732-974-3937",
            "fax_number": "732-974-6899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 SEA GIRT AVE",
            "city": "SEA GIRT",
            "state": "NJ",
            "postal_code": "087502803",
            "telephone_number": "732-974-3937",
            "fax_number": "732-974-6899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHIBBS",
        "first_name": "SEAN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2014-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "NJ4756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sea Girt, NJ

Sources for this page

Verify at the official NPI Registry.