Active NPI
Michael A Doerr, O.D.
- Optometrist
- Rockaway, NJ
National Provider Identifier
1174660757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5464
- Practice address
- 381 Mount Hope Ave
Rockaway, NJ 07866-1645 - Phone
- (973) 891-3178
- NPI assigned
- Jan 31, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 27OA00546400 | NJ | |
| Optometrist | 152W00000X | 5464 | NJ | Primary |
Addresses
Primary practice location
381 Mount Hope Ave
Rockaway, NJ 07866-1645
Mailing address
48 Ann St
Verona, NJ 07044-1906
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27OA00546400 | NJ | MD | Optometrist |
| 5464 | NJ | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710720000000",
"number": "1174660757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "48 ANN ST",
"city": "VERONA",
"state": "NJ",
"postal_code": "070441906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "381 MOUNT HOPE AVE",
"city": "ROCKAWAY",
"state": "NJ",
"postal_code": "078661645",
"telephone_number": "973-891-3178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOERR",
"first_name": "MICHAEL",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-31",
"last_updated": "2024-03-18",
"certification_date": "2024-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NJ",
"license": "27OA00546400",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NJ",
"license": "5464",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockaway, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.