Jonathan J Dorn, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA00505500 Issued in NJ

Practice address

1206 Route 72 W
Manahawkin, NJ 08050-2414

Phone

(609) 597-8087

Fax

(609) 597-7192

NPI assigned

Jun 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 14

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

Specialty

Optometry

Education

Pennsylvania College of Optometry, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Shores Eye Center, P.a.Group PAC ID 4981683711, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Southern Shores Eye Center, P.a.

  • Ophthalmology Physician
  • Manahawkin, NJ
  • NPI 1669421194

  Optometrist

  Medicare reassignment Care Compare group NPD
• Atlantic Cumberland Eye Associates

  • Ophthalmology Physician
  • Linwood, NJ
  • NPI 1154349793

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1154327435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 ROUTE 72 W",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "080502414",
            "telephone_number": "609-597-8087",
            "fax_number": "609-597-7192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 ROUTE 72 W",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "080502414",
            "telephone_number": "609-597-8087",
            "fax_number": "609-597-7192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORN",
        "first_name": "JONATHAN",
        "middle_name": "J",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OM00013700",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00505500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0045402",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0448874000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTHCARE",
            "identifier": "1066306",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NVA",
            "identifier": "311078",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "3429901000",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0099937",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "13738",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7497806",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ LICENSE",
            "identifier": "27OA00505500",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "191112",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "1K6864",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6021624",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD TRAVELERS",
            "identifier": "P00616550",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "38180",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Lynn Dittus, P.T.A
• Stephanie A Dolan, PA-C
• Dominick Cringoli
• Kristen Nicole Donadio, MSW
• Karen M Dorfman
• Dr. Andrew L. Romano D.O. LLC
• Neil Gregory Dreizen, M.D.
• Elena Rios Drudy, M.D.
• Eastern Dental of Manahawkin, LLC
• Keely Elizabeth Eckberg, FNP

• Optometrist in Manahawkin, NJ
• Providers in Manahawkin, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.