Individual provider Active NPI

Brenda K Lynly, OD

  • Optometrist
  • Berkeley Heights, NJ
National Provider Identifier
1174608640
Registry record updated May 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OM00043100 Issued in NJ
Practice address
369 Springfield Avenue
Suburban Eye Institute
Berkeley Heights, NJ 07922-1170
Phone
(908) 464-0123
Fax
(908) 665-2936
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 270A00545500 NJ
Optometrist 152W00000X 27OM00043100 NJ Primary

Addresses

Primary practice location

369 Springfield Avenue
Suburban Eye Institute
Berkeley Heights, NJ 07922-1170

Mailing address

410 Mt Arlington Blvd
Landing, NJ 07850-1315
Phone (973) 770-4706

Other names 1

  • Dr. Brenda L Kamsler Former name

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
I20080609000172 NJ Practitioner - Optometry 7911077540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
270A00545500NJMDOptometrist
27OM00043100NJMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209945600000",
    "number": "1174608640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 MT ARLINGTON BLVD",
            "city": "LANDING",
            "state": "NJ",
            "postal_code": "078501315",
            "telephone_number": "973-770-4706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 SPRINGFIELD AVENUE",
            "address_2": "SUBURBAN EYE INSTITUTE",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079221170",
            "telephone_number": "908-464-0123",
            "fax_number": "908-665-2936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNLY",
        "first_name": "BRENDA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2008-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "270A00545500",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OM00043100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDA",
            "last_name": "KAMSLER",
            "middle_name": "L",
            "prefix": "DR.",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Berkeley Heights, NJ

Sources for this page

Verify at the official NPI Registry.